Safety of Anterior Cervical Corpectomy and Fusion (ACCF) for the Treatment of Subaxial Cervical Spine Injuries, a Single Center Comparative Matched Analysis

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 2024 Jul 3

PMID 38960897

Authors

Victor Gabriel El-Hajj

Aman Singh

Alexander Fletcher-Sandersjoo

Simon Blixt

Vasilios Stenimahitis

Gunnar Nilsson

Paul Gerdhem

Erik Edstrom

Adrian Elmi-Terander

Affiliations

Soon will be listed here.

Abstract

Introduction: Anterior Cervical Discectomy and Fusion (ACDF) and Anterior Cervical Corpectomy and Fusion (ACCF) are both common surgical procedures in the management of pathologies of the subaxial cervical spine. While recent reviews have demonstrated ACCF to provide better decompression results compared to ACDF, the procedure has been associated with increased surgical risks. Nonetheless, the use of ACCF in a traumatic context has been poorly described. The aim of this study was to assess the safety of ACCF as compared to the more commonly performed ACDF.

Methods: All patients undergoing ACCF or ACDF for subaxial cervical spine injuries spanning over 2 disc-spaces and 3 vertebral-levels, between 2006 and 2018, at the study center, were eligible for inclusion. Patients were matched based on age and preoperative ASIA score.

Results: After matching, 60 patients were included in the matched analysis, where 30 underwent ACDF and ACCF, respectively. Vertebral body injury was significantly more common in the ACCF group (p = 0.002), while traumatic disc rupture was more frequent in the ACDF group (p = 0.032). There were no statistically significant differences in the rates of surgical complications, including implant failure, wound infection, dysphagia, CSF leakage between the groups (p ≥ 0.05). The rates of revision surgeries (p > 0.999), mortality (p = 0.222), and long-term ASIA scores (p = 0.081) were also similar.

Conclusion: Results of both unmatched and matched analyses indicate that ACCF has comparable outcomes and no additional risks compared to ACDF. It is thus a safe approach and should be considered for patients with extensive anterior column injury.

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