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

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

doi:10.1007/s00402-019-03182-y

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…This approach consists of C-4 and C-6 corpectomy, C-5 preservation, and C4–5 and C5–7 grafting with instrumentation of C-3, C-5, and C-7 [42]. While this technique has not been analyzed extensively in patients with OPLL, a recent comparison of ACAF and SCF demonstrated better 6-month fusion rate and significantly fewer CSF leaks in patients treated with ACAF (0%) compared to SCF (16.7%, p<0.05) [44].…”

Section: Discussionmentioning

confidence: 99%

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

et al. 2019

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Ossification of the posterior longitudinal ligament (OPLL) is a rare but potentially devastating cause of degenerative cervical myelopathy (DCM). Decompressive surgery is the standard of care for OPLL and can be achieved through anterior, posterior, or combined approaches to the cervical spine. Surgical correction of OPLL via any approach is associated with higher rates of complications and the presence of OPLL is considered a significant risk factor for perioperative complications in DCM surgeries. Potential complications include dural tear (DT) and subsequent cerebrospinal fluid leak, C5 palsy, hematoma, hardware failure, surgical site infections, and other neurological deficits. Anterior approaches are technically more demanding and associated with higher rates of DT but offer greater access to ventral OPLL pathology. Posterior approaches are associated with lower rates of complications but may allow for continued disease progression. Therefore, the decision to pursue either an anterior or posterior approach to surgical decompression may be critically influenced by complications associated with each procedure. The authors critically review anterior and posterior approaches to surgical decompression of OPLL with particular focus on the complications associated with each approach. We also review the recent work in developing new surgical treatments for OPLL that aim to reduce complication incidence.

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Section: Discussionmentioning

confidence: 99%

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

et al. 2019

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“…Through this technique, the cervical spinal cord could get more direct, safe and effective decompression. Compared with traditional cervical surgery, ACAF has a better postoperative effect and a lower incidence of complications 5–7 …”

Section: Introductionmentioning

confidence: 99%

“…Compared with traditional cervical surgery, ACAF has a better postoperative effect and a lower incidence of complications. 5 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] The key procedure of ACAF was removing part of the vertebrae to provide enough space for lifting the related vertebrae forward and achieve direct decompression of spinal cord. 5 It has been reported that the completion of the lifting procedure was closely related to the postoperative effect of ACAF. 6 However, in the actual surgical procedure, we were unable to measure the accurate thickness of vertebrae.…”

Section: Introductionmentioning

confidence: 99%

“…Compared with traditional cervical surgery, ACAF has a better postoperative effect and a lower incidence of complications. [5][6][7] The key procedure of ACAF was removing part of the vertebrae to provide enough space for lifting the related vertebrae forward and achieve direct decompression of spinal cord. 5 It has been reported that the completion of the lifting procedure was closely related to the postoperative effect of ACAF.…”

Section: Introductionmentioning

confidence: 99%

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Cervical Anatomical Landmarks Indicate the Amount of Vertebra Resection during ACAF Surgery: A Semi‐Quantitative Anatomical Parameter Study on Imaging Data

Pang

Ling

Zhang

et al. 2022

Orthopaedic Surgery

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Objective: With the innovation and development of cervical spine surgical procedures, there is currently a lack of new and reliable data on cervical anatomical landmarks. The purpose of this study is to measure the CT data of the cervical vertebrae of healthy volunteers, so as to make up for the missing part of the measured value of cervical vertebra bone markers, and provide data support for the safety and accuracy of anterior controllable antedisplacement and fusion (ACAF) surgery.Methods: From January 2019 to January 2020, the cervical computed tomography (CT) scan image data of volunteers in Changhai Hospital and Zhabei Hospital were randomly selected. The radiological parameters included three parameters were measured in the upper lamina plane. a: the distance from the anterior edge of the vertebral body to the anterior edge of the bilateral uncinate joint; c1: the sagittal diameter of the vertebral body; and d: the distance between the anterior edge of the uncinate joint. Three parameters were measured in the pedicle plane. b: the vertical distance from the anterior edge of the vertebral body to the junction line between the two lateral processes; c2: the sagittal diameter of the vertebral body; e: the transverse diameter of the vertebral body; and f: the sagittal diameter of the vertebral canal. The correlation ratios were calculated: a/c1, b/c2, a/f, b/f, d/e. The data between the two groups were compared by independent sample t-test.Results: Finally, 51 patients were included in this study, 18 males and 33 females, with an average age of 47.9 years (21-72 years). The maximum values of seven parameters measured were all at C7. The minimum b value was at C5, and the minimum f value was at C4. The minimum values of the other five parameters were all at C3, and there was an increasing relationship from C3 to C7 (P < 0.05). There was significant difference between male and female with regard to c1, c2, e and d values (P < 0.05). No significant differences were observed between men and women regard to the ratio of related parameters (a/c1, b/c2, a/f, b/f, d/e).Conclusions: Anatomical consideration of this area is useful to estimate amount of vertebral body resection when performing the bony cut made in ACAF surgery; however, pre-operative examinations with appropriate radiographic analysis are also recommended.

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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

et al. 2021

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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?

Cited by 11 publications

References 20 publications

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

Cervical Anatomical Landmarks Indicate the Amount of Vertebra Resection during ACAF Surgery: A Semi‐Quantitative Anatomical Parameter Study on Imaging Data

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

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