"Skip" corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified posterior longitudinal ligament

J Neurosurg Spine. 2010 Jan;12(1):33-8. doi: 10.3171/2009.7.SPINE08965.

Abstract

Object: The authors reviewed the results of "skip" corpectomy in 29 patients with multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL).

Methods: The skip corpectomy technique, which is characterized by C-4 and C-6 corpectomy, C-5 osteophytectomy, and C-5 vertebral body preservation, was used for decompression in patients with multilevel CSM and OPLL. All patients underwent spinal fixation using C4-5 and C5-6 grafts, and anterior cervical plates were fixated at C-3, C-5, and C-7.

Results: The mean preoperative Japanese Orthopaedic Association score increased from 13.44 +/- 2.81 to 16.16 +/- 2.19 after surgery (p < 0.05). The cervical lordosis improved from 1.16 +/- 11.74 degrees to 14.36 +/- 7.85 degrees after surgery (p < 0.05). The complications included temporary hoarseness in 3 cases, dysphagia in 1 case, C-5 nerve palsy in 1 case, and C-7 screw pullout in 1 case. The mean follow-up was 23.2 months. The final plain radiographs showed improved cervical lordosis and fusion in all cases.

Conclusions: The authors conclude that the preservation of the C-5 vertebral body provided an additional screw purchase and strengthened the construct. The results of the current study demonstrated effectiveness and safety of the skip corpectomy in patients with multilevel CSM and OPLL.

MeSH terms

  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery*
  • Decompression, Surgical / methods*
  • Magnetic Resonance Imaging
  • Ossification of Posterior Longitudinal Ligament / diagnosis
  • Ossification of Posterior Longitudinal Ligament / surgery*
  • Postoperative Complications / diagnosis
  • Spinal Cord Compression / diagnosis
  • Spinal Cord Compression / surgery*
  • Spinal Fusion / methods*
  • Spinal Osteophytosis / diagnosis
  • Spinal Osteophytosis / surgery*
  • Spondylosis / diagnosis
  • Spondylosis / surgery*
  • Tomography, X-Ray Computed