Anterior One- and Two-Level Cervical Corpectomy and Fusion for Cervical Spondylotic Myelopathy: A Retrospective Study
Abstract
Introduction: Anterior cervical corpectomy is a frequently employed surgical procedure used to decompress the spinal cord in the surgical treatment of cervical spondylotic myelopathy.This study investigated the clinical and radiologic outcomes and complications of one- and two-level anterior cervical corpectomy. Methods: A retrospective evaluation was conducted on patients with cervical spondylotic myelopathy who underwent one- and two-level anterior cervical corpectomy between 2006 and 2022. The primary outcomes were clinically assessed using the visual analog scale to measure neck pain and radiologically based on the sagittal C2–C7 and T1 slope angles. Further, the results were evaluated in terms of complications and fusion. Results: The one-level and two-level corpectomy groups comprised 16 and 9 patients, respectively, resulting in a total of 25 patients who underwent anterior cervical corpectomy. The postoperative visual analog scale scores significantly decreased in both groups compared with that of baseline (p = 0.001; p < 0.01 and p = 0.007; p < 0.01). Similarly, the postoperative T1 slope angle showed a significant decrease compared with that of baseline in both groups (p = 0.001; p < 0.01 and p = 0.007; p < 0.01), while the postoperative C2–C7 angle significantly increased in both groups compared with that of baseline (p = 0.001; p < 0.01 and p = 0.007; p < 0.01). However, no significant differences were observed in terms of preoperative and postoperative visual analog scale scores, T1 slope angle, C2–C7 angles, and changes from baseline between the groups (p > 0.05), (p = 0.637; p > 0.05), (p = 0.169; p > 0.05), and (p > 0.05), (p = 0.452; p > 0.05). The operation duration for patients in the two-level group was significantly longer than that in the one-level group (p = 0.007; p < 0.01). Conclusion: The study findings indicated no significant clinical or radiological differences between cases undergoing one-level and two-level anterior corpectomy, except for the differences observed in operation duration. While anterior cervical corpectomy presents surgical challenges and carries a relatively higher risk of complications, meticulous surgical techniques can yield satisfactory outcomes, particularly in the context of one- and two-level anterior corpectomy.
References
- Kotil K,Tari R. Two level cervical corpectomy with iliac crest fusion and rigid plate fixation: a retrospective study with a three-year follow-up. Turkish Neurosurgery. 2011;21(4):606-12.
- Boni M, Cherubino P, DENARO V, Benazzo F. Multiple Subtotal Somatectomy. Spine. 1984 May 1;9(4):358–62.
- Tatter C, Persson O, Gustav Burström, Edström E, Elmi-Terander A. Anterior Cervical Corpectomy and Fusion for Degenerative and Traumatic Spine Disorders, Single-Center Experience of a Case Series of 119 Patients. Operative Neurosurgery. 2020 Jul 31;20(1):8–17.
- Oni P, Schultheiß R, Scheufler KM, Roberg J, Harati A. Radiological and Clinical Outcome after Multilevel Anterior Cervical Discectomy and/or Corpectomy and Fixation. Journal of Clinical Medicine. 2018 Nov 23;7(12):469.
- Lee SH, Son DW, Lee JS, et al. Differences in Cervical Sagittal Alignment Changes in Patients Undergoing Laminoplasty and Anterior Cervical Discectomy and Fusion. Neurospine. 2018 Mar 31;15(1):91–100.
- Thompson SE, Smith ZA, Hsu WK, et al. C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases. Global Spine Journal. 2017 Apr;7(1_suppl):64S70S.
- Yu S, Li F, Yan N, et al. Anterior Fusion Technique for Multilevel Cervical Spondylotic Myelopathy: A Retrospective Analysis of Surgical Outcome of Patients with Different Number of Levels Fused. PLOS ONE. 2014 Mar 11;9(3):e91329–9.
- Harrison DE, Harrison DD, Cailliet R, et al. Cobb Method or Harrison Posterior Tangent Method. Spine. 2000 Aug;25(16):2072–8.
- Tome-Bermejo F, Álvarez-Galovich L, Piñera-Parrilla ÁR, et al. Anterior 1-2 Level Cervical Corpectomy and Fusion for Degenerative Cervical Disease: A Retrospective Study With Lordotic Porous Tantalum Cages. Long-Term Changes in Sagittal Alignment and Their Clinical and Radiological Implications After Cage Subsidence. International Journal of Spine Surgery [Internet]. 2022 Apr 1 [cited 2023 Sep 5];16(2):222–32.
- Bayerl S, Florian Pöhlmann, Finger T, Prinz V, Vajkoczy P. Two-level cervical corpectomy—long-term follow-up reveals the high rate of material failure in patients, who received an anterior approach only. Neurosurgical Review. 2018 Jun 18;42(2):511–8.
- Lau D, Chou D, Mummaneni PV. Two-level corpectomy versus three-level discectomy for cervical spondylotic myelopathy: a comparison of perioperative, radiographic, and clinical outcomes. Journal of Neurosurgery: Spine. 2015 Sep;23(3):280–9.
- Ozgen S, Naderi S, Ozek MM, Pamir MN. A retrospective review of cervical corpectomy: indications, complications and outcome. Acta Neurochirurgica. 2004 Aug 16;146(10):1099–105
- Hartmann S, Pujan Kavakebi, Christoph Wipplinger, et al. Retrospective analysis of cervical corpectomies: implant-related complications of one- and two-level corpectomies in 45 patients. Neurosurgical Review. 2017 Apr 17;41(1):285–90.
Servikal Spondilotik Miyelopatide Ön Bir ve İki Seviyeli Servikal Korpektomi ve Füzyon: Retrospektif Bir Çalışma
Abstract
Amaç: Anterior servikal korpektomi, servikal myelopatik spondilopatinin cerrahi tedavisinde spinal kordun dekompresyonunu sağlamak için kullanılan yaygın bir omurga cerrahisi prosedürüdür. Bu çalışmanın amacı bir ve iki seviye anterior servikal korpektominin klinik,radyolojik sonuçlarını ve komplikasyonlarını araştırmaktır. Yöntem: 2006 -2022 yılları arasında bir ve iki seviyeli anterior servikal korpektomi cerrahisi uygulanan servikal spondilotik myelopati hastaları rekrospektif olarak değerlendirmeye alınmıştır. Birincil olarak vakaların sonuçları klinik olarak vizüel analog skala (VAS) ile ölçülen boyun ağrısı ile, radyolojik olarak sagittal c2-c7 ve T1 slope açısı üzerinden değerlendirilmiştir. İkincil olarak sonuçlar komplikasyonlar ve füzyon açısından değerlendirilmiştir. Bulgular: Bir seviyeli korpektomi grubunda 16, iki seviyeli korpektomi grubunda 9 hasta yer aldı ve toplam 25 hastaya anterior servikal korpektomi uygulanmıştır. Her iki grubun postoperatif vas değerleri preoperatife göre anlamlı derecede azalmıştır. (p=0,001; p<0,01) ve (p=0,007; p<0,01) Her iki grubun preoperatife göre t1 slop açısı postoperatif anlamlı derecede azalmıştır. (p=0,001; p<0,01), (p=0,007; p<0,01) Yine her iki grubun preoperatife göre postoperatif c2-c7 açısı anlamlı derecede artmıştır. (p=0,001; p<0,01), (p=0,007; p<0,01) Ancak gruplar arasında preoperatif ve postoperatif vas, t1 slop açı ,c2-c7 açı değerleri ve değişimleri arasında fark bulunmadı. (p>0,05), (p=0,637; p>0,05) ve (p>0,05), (p=0,169; p>0,05) ve (p>0,05),(p=0,452; p>0,05) İki seviye grubundaki olguların ameliyat süresi, bir seviye grubundan istatistiksel olarak anlamlı düzeyde uzun saptanmıştır (p=0,007; p<0,01). Sonuç: Elde edilen bulgulara göre bir seviye ve iki seviyeli anterior korpektomi vakalarının arasında klinik ve radyolojik olarak ameliyat süresi dışında fark tesbit edilmedi. Anterior servikal korpektomi zorlu bir ameliyat tekniği olması ve nisbeten fazla komplikasyonları olmasına rağmen özenli bir cerrahi uygulama ile özellikle bir ve iki seviye anterior korpektomide tatminkar sonuçlar alınabilir.
References
- Kotil K,Tari R. Two level cervical corpectomy with iliac crest fusion and rigid plate fixation: a retrospective study with a three-year follow-up. Turkish Neurosurgery. 2011;21(4):606-12.
- Boni M, Cherubino P, DENARO V, Benazzo F. Multiple Subtotal Somatectomy. Spine. 1984 May 1;9(4):358–62.
- Tatter C, Persson O, Gustav Burström, Edström E, Elmi-Terander A. Anterior Cervical Corpectomy and Fusion for Degenerative and Traumatic Spine Disorders, Single-Center Experience of a Case Series of 119 Patients. Operative Neurosurgery. 2020 Jul 31;20(1):8–17.
- Oni P, Schultheiß R, Scheufler KM, Roberg J, Harati A. Radiological and Clinical Outcome after Multilevel Anterior Cervical Discectomy and/or Corpectomy and Fixation. Journal of Clinical Medicine. 2018 Nov 23;7(12):469.
- Lee SH, Son DW, Lee JS, et al. Differences in Cervical Sagittal Alignment Changes in Patients Undergoing Laminoplasty and Anterior Cervical Discectomy and Fusion. Neurospine. 2018 Mar 31;15(1):91–100.
- Thompson SE, Smith ZA, Hsu WK, et al. C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases. Global Spine Journal. 2017 Apr;7(1_suppl):64S70S.
- Yu S, Li F, Yan N, et al. Anterior Fusion Technique for Multilevel Cervical Spondylotic Myelopathy: A Retrospective Analysis of Surgical Outcome of Patients with Different Number of Levels Fused. PLOS ONE. 2014 Mar 11;9(3):e91329–9.
- Harrison DE, Harrison DD, Cailliet R, et al. Cobb Method or Harrison Posterior Tangent Method. Spine. 2000 Aug;25(16):2072–8.
- Tome-Bermejo F, Álvarez-Galovich L, Piñera-Parrilla ÁR, et al. Anterior 1-2 Level Cervical Corpectomy and Fusion for Degenerative Cervical Disease: A Retrospective Study With Lordotic Porous Tantalum Cages. Long-Term Changes in Sagittal Alignment and Their Clinical and Radiological Implications After Cage Subsidence. International Journal of Spine Surgery [Internet]. 2022 Apr 1 [cited 2023 Sep 5];16(2):222–32.
- Bayerl S, Florian Pöhlmann, Finger T, Prinz V, Vajkoczy P. Two-level cervical corpectomy—long-term follow-up reveals the high rate of material failure in patients, who received an anterior approach only. Neurosurgical Review. 2018 Jun 18;42(2):511–8.
- Lau D, Chou D, Mummaneni PV. Two-level corpectomy versus three-level discectomy for cervical spondylotic myelopathy: a comparison of perioperative, radiographic, and clinical outcomes. Journal of Neurosurgery: Spine. 2015 Sep;23(3):280–9.
- Ozgen S, Naderi S, Ozek MM, Pamir MN. A retrospective review of cervical corpectomy: indications, complications and outcome. Acta Neurochirurgica. 2004 Aug 16;146(10):1099–105
- Hartmann S, Pujan Kavakebi, Christoph Wipplinger, et al. Retrospective analysis of cervical corpectomies: implant-related complications of one- and two-level corpectomies in 45 patients. Neurosurgical Review. 2017 Apr 17;41(1):285–90.
Details
| Primary Language | English |
|---|---|
| Subjects | One Health |
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 29, 2024 |
| Submission Date | December 25, 2023 |
| Acceptance Date | March 26, 2024 |
| Published in Issue | Year 2024 |