Skip to main content
SpringerLink
Log in

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

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Hirabayashi K, Satomi K, Toyama Y (1998) Surgical management of OPLL: anterior versus posterior approach, Part II. In: The Cervical Spine Research Society Editorial Committee, ed. The Cervical Spine. 3rd edn. Lippincott-Raven, Philadelphia, pp 876–887

  2. Qizhi S, Xuelei W, Lili Y, Lei L, Linwei C, Yang L et al (2012) Segmental anterior decompression and fusion for multilevel ossification of the posterior longitudinal ligament. Orthopedics 35(3):e403

    PubMed  Google Scholar 

  3. Liu T, Xu W, Cheng T, Yang HL (2011) Anterior versus posterior surgery for multilevel cervical myelopathy, which one is better? A systematic review. Eur Spine J 20(2):224–235

    Article  Google Scholar 

  4. Bailey RW, Badgley CE (1960) Stabilization of the cervical spine by anterior fusion. J Bone Joint Surg Am 42(3):565

    Article  Google Scholar 

  5. Matz PG, Pritchard PR, Hadley MN (2007) Anterior cervical approach for the treatment of cervical myelopathy. Neurosurgery 60(1):64–70

    Google Scholar 

  6. Sasso RC Jr, Reilly RR, Hall PV (2003) Early reconstruction failures after multilevel cervical corpectomy. Spine 28(2):140–142

    Article  Google Scholar 

  7. Epstein N (1992) Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J 2(6):436–449

    Article  Google Scholar 

  8. Jain SK, Salunke PS, Vyas KH, Behari SS, Banerji D, Jain VK (2005) Multisegmental cervical ossification of the posterior longitudinal ligament: anterior vs posterior approach. Neurol India 53(3):283–285

    Article  Google Scholar 

  9. Fujimori T, Iwasaki M, Okuda S, Takenaka S, Kashii M, Kaito T et al (2014) Long-term results of cervical myelopathy due to ossification of the posterior longitudinal ligament with an occupying ratio of 60% or more. Spine 39(1):58–67

    Article  Google Scholar 

  10. Ashkenazi E, Smorgick Y, Rand N, Millgram MA, Mirovsky Y, Floman Y (2005) Anterior decompression combined with corpectomies and discectomies in the management of multilevel cervical myelopathy: a hybrid decompression and fixation technique. J Neurosurg Spine 3(3):205–209

    Article  Google Scholar 

  11. Bone E (2010) “Skip” corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified poster. Spinal Fusion 12:33–38

    Google Scholar 

  12. Dalbayrak S, Yilmaz M, Naderi S (2010) “Skip” corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified posterior longitudinal ligament. J Neurosurg Spine 12(1):33

    Article  Google Scholar 

  13. Qian L, Jiang S, Liu Z, Cheng L, Zeng Z, Jia Y et al (2014) Comparison of the safety and efficacy of anterior ‘skip’ corpectomy versus posterior decompression in the treatment of cervical spondylotic myelopathy. J Orthopaedic Surg Res 9(1):1–6

    Article  Google Scholar 

  14. Sun J, Shi J, Xu X, Yang Y, Wang Y, Kong Q et al (2017) Anterior controllable antidisplacement and fusion surgery for the treatment of multilevel severe ossification of the posterior longitudinal ligament with myelopathy: preliminary clinical results of a novel technique. Eur Spine J 27(6):1–10

    Google Scholar 

  15. Sun JC, Zhang B, Shi J, Sun KQ, Le H, Xiao FS et al (2018) Can k-line predict the clinical outcome of anterior controllable antedisplacement and fusion surgery for cervical myelopathy caused by multi-segmental ossification of the posterior longitudinal ligament? World Neurosurgery e116:e118–e127

    Article  Google Scholar 

  16. Eck KR, Lenke LG, Bridwell KH, Gilula LA, Lashgari CJ, Riew KD (2000) Radiographic assessment of anterior titanium mesh cages. J Spinal Disord 13(6):501–509

    Article  CAS  Google Scholar 

  17. Song KJ, Lee KB (2012) Efficacy of multilevel anterior cervical discectomy and fusion versus corpectomy and fusion for multilevel cervical spondylotic myelopathy: a minimum 5-year follow-up study [J]. Eur Spine J 21(8):1551–1557

    Article  Google Scholar 

  18. Daniels AH, Riew KD, Yoo JU, Ching A, Birchard KR, Kranenburg AJ et al (2008) Adverse events associated with anterior cervical spine surgery. JAAOS 16(12):729–738

    PubMed  Google Scholar 

  19. Jeon I, Cho YE (2018) Analysis of factors contributing to repeat surgery in multi-segments cervical ossification of posterior longitudinal ligament. J Korean Neurosurg Soc 61(2):224–232

    Article  Google Scholar 

  20. Yilmaz M, Yüksel KZ, Baek S et al (2012) Biomechanics of cervical ‘skip’ corpectomy versus standard multilevel corpectomy [J]. J Spinal Disord Tech 2:e783–e789

    Google Scholar 

  21. Sun JC, Yang HS, Shi J, Yuan W, Xu XM, Shi GD et al (2018) Morphometric analysis of uncinate process as a landmark for anterior controllable antedisplacement and fusion surgery: a study of radiological anatomy. World Neurosurg 113:e101–e107

    Article  Google Scholar 

  22. Lin Q, Zhou X, Wang X et al (2012) A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy. Eur Spine J 21(3):474–481

    Article  Google Scholar 

  23. Hartmann S, Thomé C, Keiler A, Fritsch H, Hegewald AA, Schmölz W (2015) Biomechanical testing of circumferential instrumentation after cervical multilevel corpectomy. Eur Spine J 24(12):2788–2798

    Article  Google Scholar 

  24. Gupta A, Rajshekhar V (2016) Functional and radiological outcome in patients undergoing three level corpectomy for multi-level cervical spondylotic myelopathy and ossified posterior longitudinal ligament. Neurol India 64(1):90–96

    Article  Google Scholar 

  25. Jr AF, Aryan HE, Chou D, Ames CP (2008) Long-term biomechanical stability and clinical improvement after extended multilevel corpectomy and circumferential reconstruction of the cervical spine using titanium mesh cages. J Spinal Disord Tech 21(3):165

    Article  Google Scholar 

Download references

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).

Author information

Author notes

  1. Bin Zhang, Jingchuan Sun and Ximing Xu contributed equally to this work and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Shanghai, 200003, People’s Republic of China

    Bin Zhang, Jingchuan Sun, Ximing Xu, Jiangang Shi, Yongfei Guo, Kaiqiang Sun, Haisong Yang, Yuan Wang, Le Huan, Xiaofei Sun, Haibo Wang, Bing Zheng & Peng Zhang

  2. Department of Radiology and Nuclear Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People’s Republic of China

    Fangni Chen

Authors
  1. Bin Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jingchuan Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ximing Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiangang Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yongfei Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kaiqiang Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Haisong Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yuan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Le Huan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Xiaofei Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Haibo Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Bing Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Fangni Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Peng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Jiangang Shi or Yongfei Guo.

Ethics declarations

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.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, B., Sun, J., Xu, X. et al. Skip corpectomy and fusion (SCF) versus anterior controllable antedisplacement and fusion (ACAF): which is better for patients with multilevel cervical OPLL?. Arch Orthop Trauma Surg 139, 1533–1541 (2019). https://doi.org/10.1007/s00402-019-03182-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-019-03182-y

Keywords

Search

Navigation