Comparison of Anterior Cervical Discectomy and Fusion versus Anterior Cervical Corpectomy and Fusion in the treatment of Localized Ossification of the Posterior Longitudinal Ligament: a retrospective study

Abstract

Abstract Background: The retrospective study was conducted to compare the efficacy of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) for localized ossification of the posterior longitudinal ligament (OPLL) by evaluating clinical and radiologic outcomes. Methods: We reviewed 151 patients to assess the effects of treatment for localized OPLL. Perioperative parameters, such as blood loss, operation time and complications, were recorded. Radiologic outcomes, such as the occupying ratio (OR), fusion status,cervical lordosis angle, segmental angle, disc space height,T1 slope, and C2–C7 sagittal vertical axis (SVA), were assessed. Clinical indices, such as the JOA scores and VAS scores, were investigated to compare the two surgical options. Results: There were no significant differences in the JOA scores or VAS scores between the two groups (P>0.05). The operation time, volume of blood loss and incidence of dysphagia were significantly less in the ACDF group than in the ACCF group(P<0.05). In addition, cervical lordosis, segmental angle and disc space height were significantly different from their preoperative evaluations. Both groups had significantly improved T1 slopes. Moreover, C2–C7 SVA was significantly increased at the last follow-up. No adjacent segment degenerated in the ACDF group. The degeneration of the ACCF group was 4.1%. The incidence of CSF leaks was 7.8% in the ACDF group and 13.5% in the ACCF group. All the patients ultimately achieved successful fusion. Conclusion: Although both options achieved satisfactory primary clinical and radiographic efficacies, ACDF was associated with a shorter surgical procedure, less volume of intraoperativeblood loss, better radiologic outcomes and lower incidenceof dysphagia than ACCF.