title: Hybrid Corpectomy and Disc Arthroplasty for Cervical Spondylotic Myelopathy Caused by Ossification of Posterior Longitudinal Ligament and Disc Herniation.
abstract: OBJECTIVE
  The combination of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) has been demonstrated to be effective for multilevel cervical spondylotic myelopathy (CSM); however, the combination of ACCF and cervical disc arthroplasty (CDA) for 3-level CSM has never been addressed.
  
  
  METHODS
  Consecutive patients (>18 years of age) with CSM caused by segmental ossification of posterior longitudinal ligament (OPLL) and degenerative disc disease (DDD) were reviewed. Inclusion criteria were patients who underwent hybrid ACCF and CDA surgery for symptomatic 3-level CSM with OPLL and DDD. Medical and radiologic records were reviewed retrospectively.
  
  
  RESULTS
  A total of 15 patients were analyzed with a mean follow-up of 18.1 ± 7.42 months. Every patient had hybrid surgery composed of 1-level ACCF (for segmental-type OPLL causing spinal stenosis) and 1-level CDA at the adjacent level (for DDD causing stenosis). All clinical outcomes, including visual analogue scale of neck and arm pain, Neck Disability Index, Japanese Orthopedic Association scores, and Nurick scores of myelopathy, demonstrated significant improvement at 12 months after surgery. All patients (100%) achieved arthrodesis for the ACCF (instrumented) and preserved mobility for CDA (preoperation 6.2 ± 3.81° vs. postoperation 7.0 ± 4.18°; P = 0.579).
  
  
  CONCLUSIONS
  For patients with multilevel CSM caused by segmental OPLL and DDD, the hybrid surgery of ACCF and CDA demonstrated satisfactory clinical and radiologic outcomes. Moreover, although located next to each other, the instrumented ACCF construct and CDA still achieved solid arthrodesis and preserved mobility, respectively. Therefore, hybrid surgery may be a reasonable option for the management of CSM with OPLL.
authors.affiliation: Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Huang-Chou
authors.initials: HC
authors.lastname: Chang
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tsung-Hsi
authors.initials: TH
authors.lastname: Tu
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hsuan-Kan
authors.initials: HK
authors.lastname: Chang
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan. Electronic address: jauching@gmail.com.
authors.forename: Jau-Ching
authors.initials: JC
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Fay
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Peng-Yuan
authors.initials: PY
authors.lastname: Chang
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Ching-Lan
authors.initials: CL
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Henrich
authors.initials: H
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013130:Spinal Stenosis / Q000209:etiology / Q000601:surgery*; D055009:Spondylosis / Q000150:complications / Q000601:surgery*; D059145:Total Disc Replacement / Q000379:methods*; D016896:Treatment Outcome
keywords: Anterior cervical corpectomy and fusion; Cervical disc arthroplasty; Cervical spondylotic myelopathy; Hybrid; Ossification of posterior longitudinal ligament