• Bin Zhang, Jingchuan Sun, Ximing Xu, Jiangang Shi, Yongfei Guo, Kaiqiang Sun, Haisong Yang, Yuan Wang, Le Huan, Xiaofei Sun, Haibo Wang, Bing Zheng, Fangni Chen, and Peng Zhang.
• Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Shanghai, 200003, People's Republic of China.
• Arch Orthop Trauma Surg. 2019 Nov 1; 139 (11): 1533-1541.

BackgroundThe aim of this study was to compare the clinical efficacy and radiological outcomes of skip corpectomy and fusion (SCF) with anterior controllable antedisplacement and fusion (ACAF) for treating multilevel ossification of the posterior longitudinal ligament (OPLL).Methods62 patients with multilevel OPLL who had undergone SCF or ACAF were analyzed retrospectively. Types of OPLL, occupying ratio (OR), Japanese Orthopaedic Association (JOA) score, Recovery Rate (RR), Neck Disability Index (NDI) score, Cobb's angles of C2-C7, operation time, blood loss, hospital stay, ratings for fusion assessment and complications were recorded and assessed.ResultsPostoperative C2-C7 Cobb's angle (11.1 ± 3.2° vs. 13.7 ± 2.5°; P < 0.05), NDI scores at final follow-up (14.3 ± 1.6 vs. 13.3 ± 1.3; P < 0.05), and rate of cerebral fluid (CSF) leakage (5, 16.7% vs. 0,0%; P < 0.05) were significantly better in the ACAF group. At 6 months, bone graft fusion rate was significantly greater in the ACAF group (24.75% vs. 15.50%; P < 0.05).ConclusionsSurgical treatment of multilevel OPLL by SCF or ACAF showed no significant differences in clinical outcomes, with the exception of better NDI scores at final follow-up in ACAF. In addition, ACAF is better than SCF in terms of early bone graft fusion rate, lordotic curvature improvement, risk of CSF leakage.

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