Yao Minghe, Li Yaling, Wang Beiyu, Wu Tingkui, Huang Kangkang, Chen Shihao, Zhao Xiaoqiang, Deng Yi, Liu Hao
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Operating Room, Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Orthop Surg. 2025 Jul;17(7):2173-2182. doi: 10.1111/os.70076. Epub 2025 May 26.
Anterior cervical discectomy and fusion (ACDF) is a trans-intervertebral space procedure with limited ability to treat compression at the back of the vertebral body. Anterior cervical corpectomy and fusion (ACCF) can be applied in this case, but the higher complication rates restrict its usage. This study aims to describe an ACDF-based procedure named anterior cervical V-shaped osteotomy and fusion (ACVF) with a long axial decompression range while preserving the intact anterior half of the vertebral body.
Four patients with contiguous two-level degenerative cervical myelopathy who underwent ACVF with 12-month follow-up were retrospectively reviewed. Intraoperatively, an electrode penetration test was conducted to verify complete decompression. Clinical outcomes were evaluated using the modified Japanese Orthopedic Association (mJOA) score and the Visual Analog Scale (VAS) score. Radiological examinations, including computed tomography (CT) and magnetic resonance imaging (MRI), were used to assess spinal cord decompression and intervertebral fusion.
All surgeries were successfully completed with an average operative time of 182 min. Both the mJOA score and the VAS score improved at the follow-ups postoperatively. Postoperative imaging showed thorough decompression of the spinal cord, unimpaired fusion process, and acceptable vertebral body height loss.
ACVF may be safe and effective for spinal cord direct decompression in the case of retro-corporeal compression, with the potential to serve as a substitute for ACCF and avoid the complications associated with long-strut grafts.
颈椎前路椎间盘切除融合术（ACDF）是一种经椎间间隙的手术，治疗椎体后方压迫的能力有限。颈椎前路椎体次全切除融合术（ACCF）可用于这种情况，但较高的并发症发生率限制了其应用。本研究旨在描述一种基于ACDF的手术，即颈椎前路V形截骨融合术（ACVF），其轴向减压范围长，同时保留椎体完整的前半部分。
回顾性分析4例接受ACVF手术并随访12个月的连续性两节段退行性颈椎病患者。术中进行电极穿透试验以验证完全减压。使用改良日本骨科协会（mJOA）评分和视觉模拟量表（VAS）评分评估临床结果。包括计算机断层扫描（CT）和磁共振成像（MRI）在内的影像学检查用于评估脊髓减压和椎间融合情况。
所有手术均成功完成，平均手术时间为182分钟。术后随访时mJOA评分和VAS评分均有所改善。术后影像学检查显示脊髓彻底减压、融合过程未受影响且椎体高度丢失可接受。
ACVF对于椎体后方压迫情况下的脊髓直接减压可能是安全有效的，有潜力替代ACCF并避免与长支撑植骨相关的并发症。
