Department of Orthopedics, West China Hospital of Sichuan University, #37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, 610041, People's Republic of China.
Eur Spine J. 2024 Jan;33(1):205-215. doi: 10.1007/s00586-023-07986-w. Epub 2023 Oct 30.
Anterior cervical X-shape-corpectomy and fusion (ACXF) is a novel cervical surgery, designed as partial alternative to the classic technique, anterior cervical corpectomy and fusion (ACCF). The aim of this study was to evaluate the early-stage outcomes of ACXF in treating two-level cervical spondylosis (CS) through comparisons with ACCF.
A retrospectively comparative study was conducted in two cohorts of patients who underwent single-vertebral ACXF or ACCF to treat two-level CS during September 2019 and October 2021. Clinical and radiological data of all the patients were collected from pre-operation to 1 year after the surgery, following by intra- and intergroup analyses and comparisons.
Fifty-seven patients were included, with 24 undergoing ACXF and 33 undergoing ACCF. ACXF group had significantly shorter drainage duration (2.13 ± 0.61 days vs. 3.48 ± 1.30 days, P < 0.001) and less drainage volume (30.21 ± 26.88 ml vs. 69.30 ± 37.65 ml, P < 0.001) than ACCF group. Both techniques significantly improved all the clinical parameters (P < 0.01) with comparable effects (P > 0.05). Each complication rate in ACXF group was lower than that in ACCF group without significant difference (P > 0.05). ACXF showed a significantly smaller transverse decompression range than ACCF (11.93 ± 1.27 mm vs. 16.29 ± 1.88 mm, P < 0.001). Postoperatively, ACXF yielded a comparable fusion rate (P > 0.05) and a significantly lower subsidence rate (P < 0.01) than ACCF technique at all time points.
ACXF is a potential surgical alternative for certain patients with two-level CS, as it provides both adequate decompression range and fewer adverse events than ACCF. The further modifications on ACXF worth exploration.
前路颈椎 X 形切除术和融合术（ACXF）是一种新的颈椎手术，旨在作为经典前路颈椎切除术和融合术（ACCF）的部分替代方法。本研究旨在通过与 ACCF 比较，评估 ACXF 治疗两节段颈椎病（CS）的早期结果。
对 2019 年 9 月至 2021 年 10 月期间接受单椎体 ACXF 或 ACCF 治疗两节段 CS 的两组患者进行回顾性比较研究。所有患者均在术前至术后 1 年收集临床和影像学资料，然后进行组内和组间分析和比较。
共纳入 57 例患者，其中 24 例行 ACXF，33 例行 ACCF。ACXF 组引流时间（2.13±0.61 天 vs. 3.48±1.30 天，P<0.001）和引流量（30.21±26.88ml vs. 69.30±37.65ml，P<0.001）明显短于 ACCF 组。两种手术均明显改善所有临床参数（P<0.01），且效果相当（P>0.05）。ACXF 组各并发症发生率低于 ACCF 组，但差异无统计学意义（P>0.05）。ACXF 组的横断减压范围明显小于 ACCF 组（11.93±1.27mm vs. 16.29±1.88mm，P<0.001）。术后，ACXF 在所有时间点的融合率均相当（P>0.05），而沉降率明显低于 ACCF 组（P<0.01）。
ACXF 是治疗两节段 CS 患者的一种潜在手术选择，因为它提供了足够的减压范围和比 ACCF 更少的不良事件。进一步改进 ACXF 值得探索。
