Clinical Effect Of Controlled Anterior Cervical Vertebral Complex And Anterior Cervical Subtotal Vertebral Resection For Posterior Longitudinal Ligament Ossification

Objective:To compare the outcomes of patients with ossification of the posterior longitudinal ligament(OPLL)who underwent anterior cervical subtotal resection and fusion(ACCF)and anterior cervical vertebral ossification complex controlled anterior fusion(ACAF)in our hospital.Clinical efficacy,through the analysis and comparison of various data and data collected before and after surgery,to further explore the safety and effectiveness of the two surgical methods.Methods:Through retrospective analysis,clinical medical records of patients with posterior longitudinal ligament ossification diagnosed and treated in our hospital from July 2018 to September 2021 were collected.According to inclusion and exclusion criteria,A total of 44 patients were collected and divided into ACCF(C)group and ACAF(A)group.There were 23 cases(52.3%)in ACCF group and 21 cases(47.7%)in ACAF group.The basic data of the patients were compared and analyzed,including gender,age,symptom duration,spinal canal occupation rate,operation time,length of hospital stay,intraoperative blood loss,etc.Neurological status:JOA score,JOA score improvement rate,VAS score improvement rate,etc.Imaging examination:decompression width,spinal canal cross-sectional area,spinal sagittal diameter,spinal cord area,cerebrospinal fluid area;Surgical complications:incision hematoma,incision infection,cerebrospinal fluid leakage,spinal cord injury,etc.Results:A retrospective analysis of the data of 44 patients showed that there was no significant difference in gender,age,symptom duration,operation time,hospital stay,spinal canal occupying rate and intraoperative blood loss.The width of decompression in group A was significantly larger than that in group C(P<0.01).The postoperative spinal canal cross-sectional area,spinal cord and cerebrospinal fluid area in group A were higher than those in group C(P<0.05).The sagittal diameter of spinal cord in group A was significantly increased(P<0.05).VAS score and JOA score in group A were better than those in group C at 3 months follow-up(P<0.05).There were 1 cases of cerebrospinal fluid leakage in group C,but no cases of cerebrospinal fluid leakage in group A,and there was no significant difference in the incidence of cerebrospinal fluid leakage(P>0.05).Conclusion:For patients with OPLL,both ACCF and ACAF have higher surgical safety.However,ACAF can fully decompress the spinal cord,better recover the spinal cord and cerebrospinal fluid area,and achieve better neurological function recovery,with satisfactory clinical efficacy.