How much space of the spinal canal should be restored by hoisting the vertebrae–OPLL complex for sufficient decompression in anterior controllable antedisplacement and fusion? A multicenter clinical radiological study

Chen, Yan; Jia, Huai-Cheng; Tan, Haoyuan; Yu, Xue-Wei; Li, Ming; Zhou, Xin; Yang, Mingyuan; Song, Dianwen; Zhao, Qinghua; Li, Guozheng; Tang, Shenghui; Yu, Bo; Li, Lin-Tao; Sun, Jingchuan; Shi, Jiangang

doi:10.1016/j.spinee.2020.09.008

Cited by 7 publications

(6 citation statements)

References 36 publications

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“…Therefore, the treatment principle for SCI is to completely decompress the spinal canal and reconstruct the anterior column of the cervical spine, so as to restore the normal sequence and stability of the cervical spine and avoid nerve injury [ 16 , 17 ]. ACF combined with iliac bone graft fusion and internal fixation is the first choice for CSI, and its effectiveness has been repeatedly confirmed clinically [ 18 , 19 ]. The anterior cervical approach allows full decompression of the spinal canal under direct vision, which facilitates the reconstruction of damaged cervical vertebrae [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

Yang

Liu

Yin

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. Short-track speed skating (STSS) is an extreme sport in pursuit of extreme speed and explosive force. In such a sport, once athletes fall down, they are susceptible to serious cervical spine injury (CSI) under the inertia of high-velocity movement. Nanohydroxyapatite/polyamide 66 (NHP66) bioactive cage is a high-tech product of nanotechnology in the medical field in recent years. With a structure similar to that of human cortical bone, NHP66 bioactive cage has extremely high toughness and strength, which tailors to the needs of STSS. Objective. This study mainly analyzed the therapeutic effect of NHP66 on patients with CSI in STSS, aiming to provide new opportunities for the treatment of this patient population. Methods. A total of 51 patients with CSI treated in our hospital were enrolled, including 19 cases of short-track speed skaters (observation group) and 32 cases of car accidents, falls from heights, or collision injuries (control group). The relevant surgical indicators (operation time, intraoperative blood loss, etc.), the incidence of adverse reactions, the Cobb angle of cervical lordosis before and after surgery, and the fusion segment height of the cage were observed and compared between the two groups. Postoperative pain was evaluated by the visual analog scale (VAS), improvement of spinal cord injury was assessed by the American Spinal Cord Injury Association (ASIA) Impairment Scale, and bone fusion, bone subsidence, and other motor functions were assessed by the Japanese Orthopaedic Association (JOA) score rating system. Results. The operation time, intraoperative blood loss, and incidence of adverse reactions in the observation group were significantly lower than those in the control group. The Cobb angle of cervical lordosis and the fusion segment height of cage increased significantly higher in both groups after surgery. In addition, the VAS scores of the observation group 2 h and 3 d after operation were significantly lower than those of the control group. In terms of improvement of spinal cord injury, ASIA and JOA scores in the observation group were significantly higher than those before treatment and in the control group. There was no significant difference in bone fusion activity between the two groups. Conclusions. In this study, it is found through experiments that NHP66 has higher safety and application value than autogenous iliac bone, confirming that NHP66 can achieve significant results as a cage for anterior cervical decompression and iliac bone graft fusion and internal fixation in short-track speed skaters after CSI.

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Section: Discussionmentioning

confidence: 99%

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

Yang

Liu

Yin

et al. 2022

Computational and Mathematical Methods in Medicine

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“…It also avoids dealing with the dura mater and adhesions or ossifications; hence it offers safety in treating these patients. 6,16 Main Findings A prospective randomized trial of patients with kyphosis and high rate ossification (≥60%) treated by ACAF depicted better neurological improvement than those treated by laminoplasty. 6 However, due to the continuous development of ACAF, determining the number of hoisted vertebrae and reducing the segments to be hoisted is an important problem to be ascertained.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it preserves the integrity of the spinal canal and restores the position of the spinal cord. It also avoids dealing with the dura mater and adhesions or ossifications; hence it offers safety in treating these patients 6,16 …”

Section: Discussionmentioning

confidence: 99%

The CT Classification of Multilevel Cervical Ossification of the Posterior Longitudinal Ligament to Guide Hybrid Anterior Controllable Antedisplacement and Fusion vs. Posterior Laminoplasty

Wang,

Song,

et al. 2024

Orthopaedic Surgery

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ObjectiveFor precise and minimally invasive treatment of ossification of the posterior longitudinal ligament of the cervical spine, the lifting segment is minimized, anterior controllable antedisplacement and fusion (ACAF) was refined and improved. In addition, the development of appropriate surgical procedures for the ossification of each segment was rarely reported. Therefore, this study aimed to compare the efficacy and safety of hybrid anterior controlled antedisplacement fusion (Hybrid ACAF) with laminoplasty for multilevel ossification of the posterior longitudinal ligament (OPLL).MethodsBetween May 2018 and May 2021, 70 patients with multilevel OPLL were divided into a hybrid ACAF group and a laminoplasty group according to surgical methods. All patients were followed up for at least 1 year. Japanese Orthopaedic Association (JOA) score and recovery rate (JOARR), (VAS, NDI) score and C2–C7 Cobb angle, the sagittal vertical axis of the neck (SVA), and complications (cerebrospinal fluid leakage, C5 paralysis, etc.) were compared between the two groups by t test or non‐parametric test.ResultsThe operation time of hybrid ACAF was longer. C5 paralysis and axial pain were more common in the laminoplasty group, while dysphagia and hoarseness were more common in the hybrid ACAF group. At the last follow‐up, the hybrid ACAF group had better recovery and maintenance of cervical lordosis and sagittal plane balance and a higher JOA score and recovery rate than the laminoplasty group.ConclusionsHybrid ACAF can reduce the number of vertebral bodies and expand the decompression range, which is safe, effective, and tailored to local conditions. Compared with laminoplasty, hybrid ACAF is a precise alternative for patients with OPLL.

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“…We defined satisfactory and unsatisfactory surgical outcomes as RR ≥ 50% and < 50%, respectively. 15 , 16 …”

Section: Methodsmentioning

confidence: 99%

“…The RR for JOA scores was calculated as follows: (Last follow‐up JOA Score − Preoperative JOA Score)/(17 − Preoperative JOA Score) × 100%, 15 which represented a clinical improvement in neurologic symptoms after surgery. We defined satisfactory and unsatisfactory surgical outcomes as RR ≥ 50% and < 50%, respectively 15,16 …”

Section: Methodsmentioning

confidence: 99%

Does Focal Kyphotic Deformity at Non‐responsible Levels Affect the Outcomes of Anterior Cervical Decompression and Fusion?

Liu,

Tan,

Wang

et al. 2024

Orthopaedic Surgery

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ObjectiveFocal cervical kyphotic deformity (FCK) without neurologic compression is not uncommon in patients with cervical spondylotic myelopathy (CSM) who underwent anterior cervical decompression and fusion (ACDF) surgery. It remains unclear whether FCK at non‐responsible levels needs to be treated simultaneously. This study aims to investigate whether FCK at non‐responsible levels is the prognostic factor for CSM and elucidate the surgical indication for FCK.MethodsPatients with CSM who underwent ACDF between January 2016 and April 2021 were included. Patients were divided into two groups according to the presence of FCK and two classifications according to global cervical sagittal alignment. Clinical outcomes were compared using Japanese Orthopaedic Association (JOA) scores and recovery rate (RR) of neurologic function. Univariate and multivariate analysis based on RR assessed the relationship between various possible prognostic factors and clinical outcomes. The receiver operating characteristic curve (ROC) was used to determine the optimal cutoff value of the focal Cobb angle to predict poor clinical outcomes.ResultsA total of 94 patients were included, 41 with FCK and 53 without. Overall, the RR of neurologic function was significantly lower in the FCK than in the non‐FCK group. Further analysis showed that the RR difference between the two groups was only observed in hypo‐lordosis classification (kyphotic and sigmoid alignment), but not in the lordosis classification. Multivariate analysis showed that the preoperative focal Cobb angle in the FCK level (OR = 0.42; 95% CI = 0.18–0.97) was independently associated with clinical outcomes in the hypo‐lordosis classification. The optimal cutoff point of the preoperative focal kyphotic Cobb angle was calculated at 4.05°.ConclusionFor CSM with hypo‐lordosis, FCK was a risk factor for poor postoperative outcomes. Surgeons may consider treating the FCK simultaneously if the focal kyphotic Cobb angle of FCK is greater than 4.05° and is accompanied by cervical global kyphotic or sigmoid deformity.

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How much space of the spinal canal should be restored by hoisting the vertebrae–OPLL complex for sufficient decompression in anterior controllable antedisplacement and fusion? A multicenter clinical radiological study

Cited by 7 publications

References 36 publications

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

Efficacy of NHP66 Bioactive Cage on Patients with Cervical Spine Injury in Short-Track Speed Skating

The CT Classification of Multilevel Cervical Ossification of the Posterior Longitudinal Ligament to Guide Hybrid Anterior Controllable Antedisplacement and Fusion vs. Posterior Laminoplasty

Does Focal Kyphotic Deformity at Non‐responsible Levels Affect the Outcomes of Anterior Cervical Decompression and Fusion?

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