Combined osteotomy of Luschka joint and posterior edge of vertebral body for the treatment of severe cervical spondylosis with intervertebral stenosis or osteophyte hyperplasia: a randomized trial

Abstract

Abstract Background: Although ACDF is widely used in the treatment of cervical degenerative diseases, it cannot achieve adequate decompression for patients with severe intervertebral space stenosis or osteophyte hyperplasia. This study reports a modified technique of ACDF called anterior intervertebral osteotomy and fusion (AIOF) for the treatment of patients with this type of cervical spondylosis and compares its therapeutic effects with those of ACDF. Methods: A total of 121 patients with symptomatic cervical spondylosis who had failed to respond to conservative treatment at least for 3 months were included in the study. The patients were divided into two groups and treated with AIOF and ACDF, respectively. The effects of surgical treatment were analyzed by JOA score, VAS score, spinal canal area, spinal cord diameter and Cervical lordosis. Result: 54 patients (44.6%) were included in the AIOF group and 67 patients (55.4%) were included in the ACDF group. AIOF group and ACDF group showed no significant differences in age, sex, follow-up period, blood loss. However, the long-term prognosis of patients in AIOF group was significantly better than that in ACDF group in terms of JOA score, VAS score, spinal canal area, diameter of spinal cord and cervical lordosis (p＜0.05). Conclusion: The osteotomy of the Luschka joint and posterior edge of the vertebral body in AIOF can achieve the decompression of nerve roots and spinal cord safely and effectively. It is a better choice than ACDF for patients with severe intervertebral space stenosis and osteophyte hyperplasia.