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Hybrid Corpectomy and Disc Arthroplasty for Cervical Spondylotic Myelopathy Caused by Ossification of Posterior Longitudinal Ligament and Disc Herniation.
World Neurosurg. 2016 Nov; 95:22-30.WN

Abstract

OBJECTIVE

The combination of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) has been demonstrated to be effective for multilevel cervical spondylotic myelopathy (CSM); however, the combination of ACCF and cervical disc arthroplasty (CDA) for 3-level CSM has never been addressed.

METHODS

Consecutive patients (>18 years of age) with CSM caused by segmental ossification of posterior longitudinal ligament (OPLL) and degenerative disc disease (DDD) were reviewed. Inclusion criteria were patients who underwent hybrid ACCF and CDA surgery for symptomatic 3-level CSM with OPLL and DDD. Medical and radiologic records were reviewed retrospectively.

RESULTS

A total of 15 patients were analyzed with a mean follow-up of 18.1 ± 7.42 months. Every patient had hybrid surgery composed of 1-level ACCF (for segmental-type OPLL causing spinal stenosis) and 1-level CDA at the adjacent level (for DDD causing stenosis). All clinical outcomes, including visual analogue scale of neck and arm pain, Neck Disability Index, Japanese Orthopedic Association scores, and Nurick scores of myelopathy, demonstrated significant improvement at 12 months after surgery. All patients (100%) achieved arthrodesis for the ACCF (instrumented) and preserved mobility for CDA (preoperation 6.2 ± 3.81° vs. postoperation 7.0 ± 4.18°; P = 0.579).

CONCLUSIONS

For patients with multilevel CSM caused by segmental OPLL and DDD, the hybrid surgery of ACCF and CDA demonstrated satisfactory clinical and radiologic outcomes. Moreover, although located next to each other, the instrumented ACCF construct and CDA still achieved solid arthrodesis and preserved mobility, respectively. Therefore, hybrid surgery may be a reasonable option for the management of CSM with OPLL.

Authors+Show Affiliations

Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan. Electronic address: jauching@gmail.com.Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27474455

Citation

Chang, Huang-Chou, et al. "Hybrid Corpectomy and Disc Arthroplasty for Cervical Spondylotic Myelopathy Caused By Ossification of Posterior Longitudinal Ligament and Disc Herniation." World Neurosurgery, vol. 95, 2016, pp. 22-30.
Chang HC, Tu TH, Chang HK, et al. Hybrid Corpectomy and Disc Arthroplasty for Cervical Spondylotic Myelopathy Caused by Ossification of Posterior Longitudinal Ligament and Disc Herniation. World Neurosurg. 2016;95:22-30.
Chang, H. C., Tu, T. H., Chang, H. K., Wu, J. C., Fay, L. Y., Chang, P. Y., Wu, C. L., Huang, W. C., & Cheng, H. (2016). Hybrid Corpectomy and Disc Arthroplasty for Cervical Spondylotic Myelopathy Caused by Ossification of Posterior Longitudinal Ligament and Disc Herniation. World Neurosurgery, 95, 22-30. https://doi.org/10.1016/j.wneu.2016.07.065
Chang HC, et al. Hybrid Corpectomy and Disc Arthroplasty for Cervical Spondylotic Myelopathy Caused By Ossification of Posterior Longitudinal Ligament and Disc Herniation. World Neurosurg. 2016;95:22-30. PubMed PMID: 27474455.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hybrid Corpectomy and Disc Arthroplasty for Cervical Spondylotic Myelopathy Caused by Ossification of Posterior Longitudinal Ligament and Disc Herniation. AU - Chang,Huang-Chou, AU - Tu,Tsung-Hsi, AU - Chang,Hsuan-Kan, AU - Wu,Jau-Ching, AU - Fay,Li-Yu, AU - Chang,Peng-Yuan, AU - Wu,Ching-Lan, AU - Huang,Wen-Cheng, AU - Cheng,Henrich, Y1 - 2016/07/26/ PY - 2016/04/25/received PY - 2016/07/16/revised PY - 2016/07/18/accepted PY - 2016/7/31/pubmed PY - 2017/10/3/medline PY - 2016/7/31/entrez KW - Anterior cervical corpectomy and fusion KW - Cervical disc arthroplasty KW - Cervical spondylotic myelopathy KW - Hybrid KW - Ossification of posterior longitudinal ligament SP - 22 EP - 30 JF - World neurosurgery JO - World Neurosurg VL - 95 N2 - OBJECTIVE: The combination of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) has been demonstrated to be effective for multilevel cervical spondylotic myelopathy (CSM); however, the combination of ACCF and cervical disc arthroplasty (CDA) for 3-level CSM has never been addressed. METHODS: Consecutive patients (>18 years of age) with CSM caused by segmental ossification of posterior longitudinal ligament (OPLL) and degenerative disc disease (DDD) were reviewed. Inclusion criteria were patients who underwent hybrid ACCF and CDA surgery for symptomatic 3-level CSM with OPLL and DDD. Medical and radiologic records were reviewed retrospectively. RESULTS: A total of 15 patients were analyzed with a mean follow-up of 18.1 ± 7.42 months. Every patient had hybrid surgery composed of 1-level ACCF (for segmental-type OPLL causing spinal stenosis) and 1-level CDA at the adjacent level (for DDD causing stenosis). All clinical outcomes, including visual analogue scale of neck and arm pain, Neck Disability Index, Japanese Orthopedic Association scores, and Nurick scores of myelopathy, demonstrated significant improvement at 12 months after surgery. All patients (100%) achieved arthrodesis for the ACCF (instrumented) and preserved mobility for CDA (preoperation 6.2 ± 3.81° vs. postoperation 7.0 ± 4.18°; P = 0.579). CONCLUSIONS: For patients with multilevel CSM caused by segmental OPLL and DDD, the hybrid surgery of ACCF and CDA demonstrated satisfactory clinical and radiologic outcomes. Moreover, although located next to each other, the instrumented ACCF construct and CDA still achieved solid arthrodesis and preserved mobility, respectively. Therefore, hybrid surgery may be a reasonable option for the management of CSM with OPLL. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/27474455/Hybrid_Corpectomy_and_Disc_Arthroplasty_for_Cervical_Spondylotic_Myelopathy_Caused_by_Ossification_of_Posterior_Longitudinal_Ligament_and_Disc_Herniation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(16)30593-9 DB - PRIME DP - Unbound Medicine ER -