Clinical Comparison of Surgical Constructs for Anterior Cervical Corpectomy and Fusion in Patients With Cervical Spondylotic Myelopathy or Ossified Posterior Longitudinal Ligament

Niedzielak, Timothy; Palmer, Joseph; Malloy, John P.

doi:10.1097/bsd.0000000000000649

Cited by 17 publications

(11 citation statements)

References 51 publications

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“…Many studies have compared anterior cervical corpectomy and fusion (ACCF) with laminoplasty, ACCF, and ACDF as methods of treatment for OPLL. [ 9 , 10 ] There was no comparison of ACDF and laminoplasty for two-level localized OPLL. In our study, the clinical and radiologic outcomes of ACDF and laminoplasty for two-level localized OPLL were analyzed.…”

Section: Discussionmentioning

confidence: 99%

Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

et al. 2020

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We conducted a retrospective study to compare the clinical and radiological results of anterior cervical discectomy and fusion (ACDF) and posterior laminoplasty for two-level localized ossification of the posterior longitudinal ligament (OPLL). ACDF and posterior laminoplasty are performed for localized OPLL at the disc and vertebral body levels, respectively. Eighty six patients with two-level localized OPLL who underwent surgery from January 2011 to December 2016 were retrospectively investigated (41, ACDF group; 45, laminoplasty group). Clinical outcomes were reviewed, and radiologic results such as occupying ratio (OR), space available in the spinal cord, cranial and caudal OPLL-to-disc distance (ODD)/posterior body height (PBH) ratios, segmental angle, C2–C7 Cobb angle, T1 slope, C2–C7 sagittal vertical axis (SVA), and range of motion were investigated. Patients were followed-up for an average of 42.7 ± 10.5 months. Clinical outcomes, postoperative OR, and space available in the spinal cord were significantly improved at the final follow-up in both groups. Preoperatively, the OR and cranial and caudal ODD/PBH ratios were not significantly different between the groups. Compared to pre-operative values, differences in the segmental and C2–C7 Cobb angles at the final follow-up were statistically significant for the ACDF group ( P < .05). The mean operative time, bleeding volume, and the duration of hospitalization were significantly lower in the ACDF group than in the laminoplasty group ( P < .05). Complications occurred in 1 ACDF case and in 5 laminoplasty cases. Both ACDF and laminoplasty provided satisfactory clinical and radiologic outcomes for two-level localized OPLL. However, ACDF was associated with a lower operation time, bleeding loss, duration of hospitalization, and complications.

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Section: Discussionmentioning

confidence: 99%

Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

et al. 2020

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“…Data input into ACS NSQIP is done by a trained surgical clinical reviewer at each site with interrater reliability audits conducted at selected sites in order to ensure accurate data entry. 8 Despite the rigorous steps to ensure valid data, there are limitations to the collected data sets. First, cases are identified based on CPT codes, which introduces coding errors as a cause of misidentifying cases.…”

Section: Discussionmentioning

confidence: 99%

“…This likely results in an underestimation of the risk of some complications when such preventative efforts are not made. 8 Also, although there are more than 400 hospitals that contribute data and there is likely less bias than in single-institution studies, the ACS NSQIP data set does not represent a validated nationally representative sample. 8 As alluded to previously, one major limitation of our analysis is that there are many complications unique to cervical spine surgery that are not captured in the ACS NSQIP database.…”

Section: Discussionmentioning

confidence: 99%

Descriptive Analysis of 1972 Cervical Corpectomy Patients and 30-Day Postoperative Outcomes

Towner

Pieters

et al. 2020

Int J Spine Surg

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Background: There exists no large, multi-institutional analysis of patients undergoing cervical corpectomy for common degenerative spinal disease, including patient demographics and comorbidities as well as postoperative complications. Methods: Using Current Procedural Terminology and International Classification of Diseases codes, 1972 patients who underwent a cervical corpectomy for degenerative spinal disease were identified from the American College of Surgeons National Surgical Quality Improvement Program data sets from 2012 to 2015. A descriptive analysis of the patients who underwent the procedure as well as 30-day outcomes and adverse events were collected. Multivariate logistic regression models were used to determine the effect of any preoperative factors identified from a univariate logistic regression analysis (variables with P , .10) of complications. Results: The total complication rate, defined as major or minor adverse event, mortality, unplanned readmission, unplanned reoperation, or admission .30 days, was 13.28%. The percentage of patients who had 1 major or minor adverse events was 5.02%. Several factors commonly associated with an increased risk of perioperative complications, including smoking and diabetes, were found not to be independently associated with complications in this cohort. Conclusions: This study is the largest analysis of cervical corpectomies. The results of the multivariate analysis provide guidance on risk factors associated with perioperative complications. These data could help develop riskappropriate strategies for minimizing the effects of certain preoperative factors on perioperative complications.

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“…Anterior cervical discectomy and fusion (ACDF) has been shown to be an effective method for the treatment of CSM 3,4 . However, for patients with (1) large retrovertebral body osteophytes adjacent to the endplate, or (2) a free nucleus pulposus migrated to the vertebral body, posteriorly; known as complex cervical spondylotic myelopathy (cCSM) here; a surgeon may consider anterior cervical corpectomy and fusion (ACCF) 5,6 . In this case, ACDF may be suboptimal due to the higher chance of incomplete decompression posterior to the mid-vertebral body and limited visual access during the surgery 5,7 .…”

Section: Introductionmentioning

confidence: 99%

Is it Safe and Effective to Treat Complex Cervical Spondylotic Myelopathy Using Piezosurgery in Anterior Cervical Discectomy and Fusion?

Li¹,

Zhao²,

Wang³

et al. 2021

Preprint

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Objective To investigate the safety and efficacy of piezosurgery in anterior cervical discectomy and fusion (ACDF) for treating patients with cervical spondylotic myelopathy (CSM) coincident retrovertebral body osteophytes adjacent to the endplate or a free nucleus pulposus migrated to the vertebral body, posteriorly; known as complex cervical spondylotic myelopathy (cCSM) here.Methods Forty-seven patients with cCSM underwent ACDF surgery from 2014 to 2017. Among these patients, 26 underwent ACDF using piezosurgery (group A) and 21 underwent ACDF by traditional tools such as air drill, bone curet and gun-shaped bone forceps (group B). Average operative duration, intraoperative blood loss, surgical complications, preoperative and postoperative Japanese Orthopaedic Association (JOA) scores and improvement rate were measured.Results Average operative duration and intraoperative blood loss were signiﬁcantly lower in the piezosurgery group than those in the traditional group (P < 0.01). The incidences of surgical complications were 3.8% and 23.8% in the piezosurgery and traditional groups (P < 0.05), respectively. Whereas JOA scores and improvement rate were insigniﬁcantly diﬀerent at each data collection period (P > 0.05); preoperative, postoperative 3 days and postoperative 1 year follow-up were included.Conclusion For treating cCSM, both the piezosurgery and traditional tools led to signiﬁcant neurological improvement. However, the piezosurgery was superior to the traditional tools in terms of operative duration, blood loss, and complication rate. Hence, the piezosurgery was a safe and effective adjunct for ACDF treating cCSM.

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Clinical Comparison of Surgical Constructs for Anterior Cervical Corpectomy and Fusion in Patients With Cervical Spondylotic Myelopathy or Ossified Posterior Longitudinal Ligament

Abstract: ACCF is a common surgical option for CM, despite carrying certain risks expected of any anterior cervical approach. Several constructs are available for ACCF, all with variable clinical and radiographic outcomes.

Cited by 17 publications

References 51 publications

Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

Descriptive Analysis of 1972 Cervical Corpectomy Patients and 30-Day Postoperative Outcomes

Is it Safe and Effective to Treat Complex Cervical Spondylotic Myelopathy Using Piezosurgery in Anterior Cervical Discectomy and Fusion?

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