"Skip" corpectomy technique in multilevel cervical spondylotic myelopathy and ossified posterior longitudinal ligament: Outcomes with over 10-years follow-up

British journal of neurosurgery(2023)

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摘要
ObjectiveSkip corpectomy is a surgical technique that includes C4 and C6 corpectomies and fusion via autografts and a cervical plate and is frequently performed in patients with CSM and OPLL. This study presents long-term clinical and radiological outcomes of 48 patients who underwent skip corpectomy with 10-year follow-up.Methods48 patients who were diagnosed with CSM or OPLL were included. All patients underwent spinal canal decompression and fusion via skip corpectomy. Clinical assessment was performed using the JOA scoring system. The radiological assessment was performed using plain anteroposterior, lateral, and flexion-extension cervical spine radiographs; cervical spine MR imaging; and cervical spine CT scans. The spinal canal size, spinal cord occupation ratio, cervical lordosis, and T2 signal changes were evaluated preoperatively, and postoperatively.ResultsThe mean follow-up period was 14.6 years (13-20 years). Preoperatively, the JOA score was 11.06 +/- 3.09. The mean cervical lordosis was 2.08 degrees +/- 11.74 and the average SCOR was 62.1 +/- 14.22. There was a significant improvement in SCOR in the early postoperative period. The average cervical lordosis increased to 13.81 +/- 2.51 in the 2nd month and minimal loss of cervical lordosis was observed on the 10th year in two patients. Fusion was achieved in all patients, regardless of the graft type. None of the patients had implant failure and graft or hardware-related complications at the 10th-year follow-up.ConclusionSkip corpectomy provides efficient decompression of the spinal cord and provides adequate sagittal alignment and fusion in patients with CSM and OPLL. Long-term radiological and clinical outcomes of the technique are favorable.
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Skip corpectomy,ossified posterior longitudinal ligament,cervical spondylotic myelopathy,anterior cervical surgery
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