Microscope Enhanced the Efficacy and Safety of Anterior Cervical Surgery for Managing Cervical Ossification of the Posterior Longitudinal Ligament

Abstract

BackgroundWe aimed to compare microscope-assisted anterior cervical surgery with traditional open-base surgery for treating cervical ossification of the posterior longitudinal ligament (OPLL).Material/MethodsPatients were grouped into microscope-assisted anterior cervical surgery group (case group, n=30) and conventional anterior cervical surgery group (control group, n=30). Baseline characteristics, intraoperative and post-operative indexes including operation time, blood loss amount, duration of hospitalization, visual analogue scale (VAS), and complication rate were recorded. The neurological functions of patients were assessed using the Japanese Orthopaedic Association (JOA) score. Furthermore, the corresponding rate of improved JOA score (RIS) in each group was also calculated to evaluate surgery outcomes.ResultsThe average blood loss amount and hospital stay duration in the case group were lower than in the control group (p<0.05). The post-operative VAS scores of both groups were decreased significantly. Particularly the post-operative VAS score in the case group was significantly lower than that in the control group (p<0.05). While the improvement rate of JOA scores in the case group was significantly higher than that in control group after cervical spine surgery. A significantly higher RIS rate was observed in the case group (p<0.05). Furthermore, post-operative complications of patients in the case group were lower than those in the control group (p<0.05).ConclusionsCompared to conventional anterior cervical surgery, surgeries operated with microscope exhibit higher efficacy and safety including less bleeding amount, shorter operation time, released pain degree, improved neurological functions, and fewer incidences of complications.

An enhanced recovery after surgery pathway: LOS reduction, rapid discharge and minimal complications after anterior cervical spine surgery

“…Intraoperative use of microscopy is strongly recommended. Microscopy-assisted ACDF has been shown to reduce blood loss, postoperative pain and complications [ 43 , 44 ]. Catheterization was performed under general anesthesia to avoid embarrassment and to reduce discomfort.…”

Cervical posterior longitudinal ligament ossification

“…Advantages of anterior procedures include reduced surgical invasion, decreased blood loss and lower risk of neurological decline [5]. Microscopyassisted anterior cervical decompression is considered to be an effective surgical option [6].…”