RT Journal Article
SR Electronic
T1 Ten-Year Experience of Skip Anterior Cervical Corpectomy and Fusion
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 258
OP 264
DO 10.14444/8417
VO 17
IS 2
A1 Steve H. Monk
A1 Matthew O’Brien
A1 Stephen Perle
A1 Michael Bohl
A1 Frederick Finger
A1 Samuel J. Chewning
A1 Christopher M. Holland
YR 2023
UL http://ijssurgery.com//content/17/2/258.abstract
AB Background Anterior cervical corpectomy and fusion (ACCF) is often required to adequately decompress the spinal cord in patients with multilevel cervical spondylosis. Unfortunately, multilevel corpectomy constructs have high rates of early failure and frequently require supplemental posterior fixation. First described in 2003, skip ACCF (sACCF) is defined by corpectomies above and below an intervening vertebral body, which serves as an additional fixation point to augment biomechanical stability. Subsequent studies report high fusion rates and low construct failure rates secondary to superior biomechanical stability.Objective The goal of this study was to demonstrate the safety and efficacy of sACCF in the largest series published to date.Methods This study was a retrospective case series of all patients who underwent sACCF at a single institution over a 10-year period. Standard demographic and perioperative data were collected. Outcome data included immediate postoperative complications, long-term reoperation, and pre- and postoperative radiographic parameters.Results Forty-five patients underwent sACCF: 42 at C4-C6 and 3 at C5-C7. Mean age was 57.5 years. More than half (64.4%) of patients were smokers. Almost all patients were discharged home, the vast majority (82.2%) within 3 days of surgery. Five patients (11.1%) developed complications during the index hospitalization: 2 C5 palsies and 3 medical complications. Three patients (6.7%) developed instrumentation failure requiring anterior revision and supplemental posterior fixation. There were statistically significant increases in C1-C7 (47.8 vs 41.1, P < 0.001) and C2-C7 lordosis (11.1 vs 5.0, P < 0.001) on postoperative radiographs compared with preoperative imaging. Average follow-up was 21.1 months.Conclusion sACCF can be performed safely with complication rates similar to those reported for multilevel anterior cervical discectomy and fusion or adjacent segment ACCF. It should be considered for patients with multilevel cervical pathology for whom an anterior approach is favored.Clinical Relevance sACCF is an effective surgical technique for multilevel cervical decompression and correction of cervical alignment.Level of Evidence 3.