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Skip corpectomy and fusion (SCF) versus anterior controllable antedisplacement and fusion (ACAF): which is better for patients with multilevel cervical OPLL?

  • Bin Zhang
  • Jingchuan Sun
  • Ximing Xu
  • Jiangang ShiEmail author
  • Yongfei GuoEmail author
  • Kaiqiang Sun
  • Haisong Yang
  • Yuan Wang
  • Le Huan
  • Xiaofei Sun
  • Haibo Wang
  • Bing Zheng
  • Fangni Chen
  • Peng Zhang
Orthopaedic Surgery
  • 30 Downloads

Abstract

Background

The aim of this study was to compare the clinical efficacy and radiological outcomes of skip corpectomy and fusion (SCF) with anterior controllable antedisplacement and fusion (ACAF) for treating multilevel ossification of the posterior longitudinal ligament (OPLL).

Methods

62 patients with multilevel OPLL who had undergone SCF or ACAF were analyzed retrospectively. Types of OPLL, occupying ratio (OR), Japanese Orthopaedic Association (JOA) score, Recovery Rate (RR), Neck Disability Index (NDI) score, Cobb’s angles of C2–C7, operation time, blood loss, hospital stay, ratings for fusion assessment and complications were recorded and assessed.

Results

Postoperative C2–C7 Cobb’s angle (11.1 ± 3.2° vs. 13.7 ± 2.5°; P < 0.05), NDI scores at final follow-up (14.3 ± 1.6 vs. 13.3 ± 1.3; P < 0.05), and rate of cerebral fluid (CSF) leakage (5, 16.7% vs. 0,0%; P < 0.05) were significantly better in the ACAF group. At 6 months, bone graft fusion rate was significantly greater in the ACAF group (24.75% vs. 15.50%; P < 0.05).

Conclusions

Surgical treatment of multilevel OPLL by SCF or ACAF showed no significant differences in clinical outcomes, with the exception of better NDI scores at final follow-up in ACAF. In addition, ACAF is better than SCF in terms of early bone graft fusion rate, lordotic curvature improvement, risk of CSF leakage.

Keywords

Skip corpectomy and fusion (SCF) Anterior controllable antedisplacement fusion (ACAF) Ossification of the posterior longitudinal ligament (OPLL) Fusion rate Complication 

Notes

Funding

This study was supported by grants from the National Natural Science. Foundation of China (No. 81650031), National Natural Science. Foundation of China (No. 81802218), and Shanghai Municipal Commission of Health and Family Planning (No. 201640262).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article was approved by Medical Ethics Committee of Shanghai Changzheng Hospital. Approval file number: 2017SL040.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, Spine Center, Changzheng HospitalSecond Military Medical UniversityShanghaiPeople’s Republic of China
  2. 2.Department of Radiology and Nuclear Medicine, Changzheng HospitalSecond Military Medical UniversityShanghaiPeople’s Republic of China

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