Anterior controllable antedisplacement and fusion: quantitative analysis of a single surgeon's learning experience

Chen, Yan; Zhao, Tianyi; Chenglong, Ji; Shi, Guodong; Guo, Yongfei; Sun, Jingchuan

doi:10.1016/j.spinee.2022.01.009

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…Altogether, hybrid ACAF takes advantage of various anterior surgical procedures and has a broad prospect. Several patient factors, such as OPLL level and size and the skills and surgical experience of the surgeon, should be considered when choosing this approach 25 . In addition, high‐quality studies should be conducted to optimize the hybrid ACAF procedure for each patient with OPLL.…”

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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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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“…Piezosurgery stops cutting when the slotting violates the transverse foramina wall and soft tissue is encountered, enabling the early detection of transverse foramina violations and avoiding vertebral artery injury. Intraoperative radiology should be performed before osteotomy. One recent study reported that ACAF surgery had a steep learning curve; specific errors were encountered in 20.9% of cases in the early phase (within 29 cases), including but not limited to oblique osteotomy and insufficient isolation of the vertebrae‐OPLL complex 25 . Although there were no VA injuries following ACAF, according to the high error rate reported, we strongly recommend that surgeons who have less experience in ACAF perform intraoperative radiology before lateral osteotomy to make sure that the slotting is not beyond the tip of the UP, especially in patients with tortuous course VAs.…”

Section: Discussionmentioning

confidence: 99%

Delayed Hemorrhage Followed by Vertebral Artery Injury during Cervical Anterior Controllable Antedisplacement and Fusion Surgery: Case Report and Literature Review

Tong

Xie

Chen

et al. 2022

Orthopaedic Surgery

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Background: Vertebral artery injury (VAI) during cervical spine surgery is rare. Anterior controllable ante-displacement and fusion (ACAF) surgery is a novel technique for treating degenerative cervical spine disorders, especially ossification of the posterior longitudinal ligament. To date, there have been no reports of VAI during cervical ACAF surgery. Here, we report a rare case of perioperative complication of VAI during ACAF surgery. The available English literature that provides treatment instructions were reviewed.Case Presentation: A patient diagnosed with mixed ossification of the posterior longitudinal ligament (OPLL) underwent ACAF surgery from C2-C6. Two level transverse foramina were ruptured, and severe bleeding was encountered during ACAF osteotomy. Hemostatic tamponade was performed using bone waxes. The patient had delayed hemorrhage on postoperative day 6. Emergence angiography revealed two vertebral artery pseudoaneurysms in the ruptured transverse foramina. A balloon-expandable covered stent was deployed to treat the pseudoaneurysm. The patient recovered without complications. Conclusion:ACAF surgery is a good choice for multiple-level OPLL disease, but special attention should be paid to VAI in the perioperative period. Intraoperative tamponade with bone wax and postoperative digital subtraction angiography (DSA) are effective in preventing disaster-related hemorrhage.

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Learning curve analyses in spine surgery: a systematic simulation-based critique of methodologies

McNamee,

Keraidi,

McDonnell

et al. 2024

The Spine Journal

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Anterior controllable antedisplacement and fusion: quantitative analysis of a single surgeon's learning experience

Cited by 3 publications

References 28 publications

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

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

Delayed Hemorrhage Followed by Vertebral Artery Injury during Cervical Anterior Controllable Antedisplacement and Fusion Surgery: Case Report and Literature Review

Learning curve analyses in spine surgery: a systematic simulation-based critique of methodologies

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