Two-Level Corpectomy and Fusion vs. Three-Level Anterior Cervical Discectomy and Fusion without Plating: Long-Term Clinical and Radiological Outcomes in a Multicentric Retrospective Analysis Article Swipe
Giorgio Lofrese
,
Sokol Trungu
,
Alba Scerrati
,
Pasquale De Bonis
,
Francesco Cultrera
,
Lorenzo Mongardi
,
Nicola Montemurro
,
Amedeo Piazza
,
Massimo Miscusi
,
Luigino Tosatto
,
Antonino Raco
,
Luca Ricciardi
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/life13071564
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/life13071564
Background: Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) represent effective alternatives in the management of multilevel cervical spondylotic myelopathy (CSM). A consensus on which of these techniques should be used is still missing. Methods: The databases of three centers were reviewed (January 2011–December 2018) for patients with three-level CSM, who underwent three-level ACDF without plating or two-level ACCF with expandable cage (VBRC) or mesh (VBRM). Demographic data, surgical strategy, complications, and implant failure were analyzed. The Neck Disability Index (NDI), the Visual Analog Scale (VAS), and the cervical lordosis were compared between the two techniques at 3 and 12 months. Logistic regression analyses investigated independent factors influencing clinical and radiological outcomes. Results: Twenty-one and twenty-two patients were included in the ACDF and ACCF groups, respectively. The median follow-up was 18 months. ACDFs were associated with better clinical outcomes at 12 months (NDI: 8.3% vs. 19.3%, p < 0.001; VAS: 1.3 vs. 2.6, p = 0.004), but with an increased risk of loss of lordosis correction ≥ 1° (OR = 4.5; p = 0.05). A higher complication rate in the ACDF group (33.3% vs. 9.1%; p = 0.05) was recorded, but it negatively influenced only short-term clinical outcomes. ACCFs with VBRC were associated with a higher risk of major complications but ensured better 12-month lordosis correction (p = 0.002). No significant differences in intraoperative blood loss were noted. Conclusions: Three-level ACDF without plating was associated with better clinical outcomes than two-level ACCF despite worse losses in lordosis correction, which is ideal for fragile patients without retrovertebral compressions. In multilevel CSM, the relationship between the degree of lordosis correction and clinical outcome advantages still needs to be investigated.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/life13071564
- https://www.mdpi.com/2075-1729/13/7/1564/pdf?version=1689337396
- OA Status
- gold
- Cited By
- 6
- References
- 31
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4384338406
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4384338406Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3390/life13071564Digital Object Identifier
- Title
-
Two-Level Corpectomy and Fusion vs. Three-Level Anterior Cervical Discectomy and Fusion without Plating: Long-Term Clinical and Radiological Outcomes in a Multicentric Retrospective AnalysisWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-07-14Full publication date if available
- Authors
-
Giorgio Lofrese, Sokol Trungu, Alba Scerrati, Pasquale De Bonis, Francesco Cultrera, Lorenzo Mongardi, Nicola Montemurro, Amedeo Piazza, Massimo Miscusi, Luigino Tosatto, Antonino Raco, Luca RicciardiList of authors in order
- Landing page
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https://doi.org/10.3390/life13071564Publisher landing page
- PDF URL
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https://www.mdpi.com/2075-1729/13/7/1564/pdf?version=1689337396Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://www.mdpi.com/2075-1729/13/7/1564/pdf?version=1689337396Direct OA link when available
- Concepts
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Medicine, Corpectomy, Visual analogue scale, Anterior cervical discectomy and fusion, Surgery, Radiological weapon, Retrospective cohort study, Implant, Complication, Lordosis, Radiography, Cervical spineTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
6Total citation count in OpenAlex
- Citations by year (recent)
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2025: 3, 2024: 3Per-year citation counts (last 5 years)
- References (count)
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31Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.ACDFs | 137 |
| abstract_inverted_index.Index | 84 |
| abstract_inverted_index.Scale | 89 |
| abstract_inverted_index.blood | 229 |
| abstract_inverted_index.data, | 72 |
| abstract_inverted_index.group | 186 |
| abstract_inverted_index.ideal | 255 |
| abstract_inverted_index.major | 213 |
| abstract_inverted_index.needs | 278 |
| abstract_inverted_index.still | 37, 277 |
| abstract_inverted_index.these | 31 |
| abstract_inverted_index.three | 43 |
| abstract_inverted_index.which | 29, 253 |
| abstract_inverted_index.worse | 248 |
| abstract_inverted_index.(33.3% | 187 |
| abstract_inverted_index.(ACCF) | 13 |
| abstract_inverted_index.(ACDF) | 6 |
| abstract_inverted_index.(CSM). | 25 |
| abstract_inverted_index.(NDI), | 85 |
| abstract_inverted_index.(VAS), | 90 |
| abstract_inverted_index.(VBRC) | 67 |
| abstract_inverted_index.0.001; | 153 |
| abstract_inverted_index.0.05). | 178 |
| abstract_inverted_index.19.3%, | 150 |
| abstract_inverted_index.Analog | 88 |
| abstract_inverted_index.Visual | 87 |
| abstract_inverted_index.better | 141, 217, 241 |
| abstract_inverted_index.degree | 269 |
| abstract_inverted_index.fusion | 5, 12 |
| abstract_inverted_index.higher | 180, 210 |
| abstract_inverted_index.losses | 249 |
| abstract_inverted_index.median | 132 |
| abstract_inverted_index.months | 146 |
| abstract_inverted_index.noted. | 232 |
| abstract_inverted_index.should | 33 |
| abstract_inverted_index.(VBRM). | 70 |
| abstract_inverted_index.0.002). | 223 |
| abstract_inverted_index.0.004), | 160 |
| abstract_inverted_index.between | 97, 267 |
| abstract_inverted_index.centers | 44 |
| abstract_inverted_index.despite | 247 |
| abstract_inverted_index.ensured | 216 |
| abstract_inverted_index.factors | 111 |
| abstract_inverted_index.failure | 78 |
| abstract_inverted_index.fragile | 257 |
| abstract_inverted_index.groups, | 129 |
| abstract_inverted_index.implant | 77 |
| abstract_inverted_index.months. | 105, 136 |
| abstract_inverted_index.outcome | 275 |
| abstract_inverted_index.plating | 60, 237 |
| abstract_inverted_index.without | 59, 236, 259 |
| abstract_inverted_index.(January | 47 |
| abstract_inverted_index.12-month | 218 |
| abstract_inverted_index.Anterior | 1 |
| abstract_inverted_index.Logistic | 106 |
| abstract_inverted_index.Methods: | 39 |
| abstract_inverted_index.Results: | 117 |
| abstract_inverted_index.analyses | 108 |
| abstract_inverted_index.anterior | 8 |
| abstract_inverted_index.cervical | 2, 9, 22, 93 |
| abstract_inverted_index.clinical | 113, 142, 201, 242, 274 |
| abstract_inverted_index.compared | 96 |
| abstract_inverted_index.included | 123 |
| abstract_inverted_index.lordosis | 94, 169, 219, 251, 271 |
| abstract_inverted_index.missing. | 38 |
| abstract_inverted_index.outcomes | 143, 243 |
| abstract_inverted_index.patients | 51, 121, 258 |
| abstract_inverted_index.reviewed | 46 |
| abstract_inverted_index.surgical | 73 |
| abstract_inverted_index.analyzed. | 80 |
| abstract_inverted_index.consensus | 27 |
| abstract_inverted_index.databases | 41 |
| abstract_inverted_index.effective | 15 |
| abstract_inverted_index.follow-up | 133 |
| abstract_inverted_index.increased | 164 |
| abstract_inverted_index.outcomes. | 116, 202 |
| abstract_inverted_index.recorded, | 194 |
| abstract_inverted_index.represent | 14 |
| abstract_inverted_index.strategy, | 74 |
| abstract_inverted_index.two-level | 62, 245 |
| abstract_inverted_index.underwent | 56 |
| abstract_inverted_index.Disability | 83 |
| abstract_inverted_index.Twenty-one | 118 |
| abstract_inverted_index.advantages | 276 |
| abstract_inverted_index.associated | 139, 207, 239 |
| abstract_inverted_index.corpectomy | 10 |
| abstract_inverted_index.correction | 170, 220, 272 |
| abstract_inverted_index.discectomy | 3 |
| abstract_inverted_index.expandable | 65 |
| abstract_inverted_index.influenced | 198 |
| abstract_inverted_index.management | 19 |
| abstract_inverted_index.multilevel | 21, 263 |
| abstract_inverted_index.myelopathy | 24 |
| abstract_inverted_index.negatively | 197 |
| abstract_inverted_index.regression | 107 |
| abstract_inverted_index.short-term | 200 |
| abstract_inverted_index.techniques | 32, 100 |
| abstract_inverted_index.twenty-two | 120 |
| abstract_inverted_index.Background: | 0 |
| abstract_inverted_index.Demographic | 71 |
| abstract_inverted_index.Three-level | 234 |
| abstract_inverted_index.correction, | 252 |
| abstract_inverted_index.differences | 226 |
| abstract_inverted_index.independent | 110 |
| abstract_inverted_index.influencing | 112 |
| abstract_inverted_index.significant | 225 |
| abstract_inverted_index.spondylotic | 23 |
| abstract_inverted_index.three-level | 53, 57 |
| abstract_inverted_index.Conclusions: | 233 |
| abstract_inverted_index.alternatives | 16 |
| abstract_inverted_index.complication | 181 |
| abstract_inverted_index.investigated | 109 |
| abstract_inverted_index.radiological | 115 |
| abstract_inverted_index.relationship | 266 |
| abstract_inverted_index.complications | 214 |
| abstract_inverted_index.compressions. | 261 |
| abstract_inverted_index.investigated. | 281 |
| abstract_inverted_index.respectively. | 130 |
| abstract_inverted_index.complications, | 75 |
| abstract_inverted_index.intraoperative | 228 |
| abstract_inverted_index.retrovertebral | 260 |
| abstract_inverted_index.2011–December | 48 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 96 |
| corresponding_author_ids | https://openalex.org/A5082615746 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 12 |
| corresponding_institution_ids | https://openalex.org/I4210125574, https://openalex.org/I861853513 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.6200000047683716 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.87878258 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |