Anterior Controllable Antedisplacement Fusion as a Choice for Degenerative Cervical Kyphosis with Stenosis: Preliminary Clinical and Radiologic Results.

Abstract

The optimal surgical procedure for degenerative cervical kyphosis with stenosis (DCKS) remains controversial. The purpose of this study is to describe the preliminary clinical and radiologic results of anterior controllable antedisplacement fusion (ACAF) as a surgical technique for DCKS. In the period from 2016 through 2017, a consecutive cohort of adults with degenerative cervical kyphosis (30° ≥ Cobb angles ≥5°) and stenosis (anteroposterior diameter of the spinal canal <12 mm) underwent ACAF, a technique making the vertebrae move forward in a hoisting manner. We retrospectively reviewed these patients, and primary outcomes of interest included operation duration, blood loss, hospital stay, kyphosis correction, decompression width, anteroposterior diameter of the spinal canal, morphology of the spinal cord, Japanese Orthopaedic Association (JOA) scores, and complications. Thirty patients were included in the study. All patients were followed for a mean of 12 months. Mean operation duration and estimated blood loss were 104.8 minutes and 221.6 mL, respectively, and the mean length of hospital stay was 5.6 days. The decompression width reached 17.7 mm. The postoperative anteroposterior diameter of the spinal canal was 14.8 mm, with a significant improvement compared with preoperation (P < 0.01). There was also significant kyphosis correction after operation (20.4° vs. 4.8°, P < 0.01). The mean JOA score was significantly better than preoperation (15.0 vs. 9.3 points; P < 0.01). There were no surgery-related complications. ACAF, correcting cervical kyphosis and simultaneously enlarging the volume of the spinal canal, is a good choice for DCKS.