• Shunmin Wang, Kaiqiang Sun, Xinming Xu, Jingchuan Sun, Yuan Wang, and Jian-Gang Shi.
• Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003, People's Republic of China; 910 Hospital of China Joint Logistics Support Force, 180 Garden Road, Fengze District, Quanzhou City, Fujian Province, People's Republic of China.
• World Neurosurg. 2024 Apr 10.

PurposeTo propose a novel surgical strategy-thoracic anterior controllable ante-displacement fusion (TACAF) to treat mT-OPLL, and investigated its safety and efficacy.MethodsBetween January 2019 and December 2021, a total of 49 patients with thoracic myelopathy due to mT-OPLL were surgically treated with TACAF were retrospectively reviewed. Patients' demographic data, radiological parameters, and surgery-related complications, m-JOA and VAS scores, thoracic kyphosis (TK), kyphosis angle in fusion area (FSK), thoracic curvature, spinal cord curvature and curvature of curved rod in surgical region, diameter and area of the spinal cord at the most compressed level were included.ResultsAll patients acquired satisfactory recovery of neurological function and overall complication rate is low at the final follow up. The mean m-JOA of the two groups respectively was 3.74±2.05, 3.67±1.95 before surgery, and 9.97±0.83, 9.80±0.68at the final followed up, with the recovery rate of 84.26±14.20,82.79±10.35%, as to VA Scores. the mean FSK was 34.50±4.46,35.33±3.44before surgery, and was restored to 20.97±5.70,22.93±6.34at the final followed up respectively, as to mean TK. (P<0.05). Spinal cord curvature was improved from 34.12±3.59,33.93±3.45before surgery to 19.47±3.53,18.80±3.17at the final follow-up respectively, as to thoracic curvature (P<0.05), and In addition, the area and diameter of the spinal cord was also significantly improved at the final follow up (all P<0.05). The curvature of the thoracic pulp and thoracic vertebra is closely related to the curvature of the rod. There was no statistically significant difference in the incidence of the pelvis and the slope value of the sacrum.ConclusionsThis strategy provides a novel solution for the treatment of mT-OPLL with favorable recovery of neurological function, the tension of spinal cord, and less complications.Copyright © 2024. Published by Elsevier Inc.

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