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: 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.
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Authors | Huang-Chou Chang, Tsung-Hsi Tu, Hsuan-Kan Chang, Jau-Ching Wu, Li-Yu Fay, Peng-Yuan Chang, Ching-Lan Wu, Wen-Cheng Huang, Henrich Cheng |
Journal | World neurosurgery
(World Neurosurg)
Vol. 95
Pg. 22-30
(Nov 2016)
ISSN: 1878-8769 [Electronic] United States |
PMID | 27474455
(Publication Type: Journal Article)
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Copyright | Copyright © 2016 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Cervical Vertebrae
(surgery)
- Decompression, Surgical
(methods)
- Female
- Humans
- Intervertebral Disc Degeneration
(complications, surgery)
- Intervertebral Disc Displacement
(complications, surgery)
- Male
- Middle Aged
- Ossification of Posterior Longitudinal Ligament
(complications, surgery)
- Retrospective Studies
- Spinal Cord Compression
(etiology, surgery)
- Spinal Fusion
(methods)
- Spinal Stenosis
(etiology, surgery)
- Spondylosis
(complications, surgery)
- Total Disc Replacement
(methods)
- Treatment Outcome
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