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Long-term follow-up after open-window corpectomy in patients with advanced cervical spondylosis and/or ossification of the posterior longitudinal ligament.

STUDY DESIGN: Prospective study was performed in case with cervical spondylosis and ossification of the posterior longitudinal ligament (OPLL).

OBJECTIVE: A novel anterior approach was defined and some patients were operated in this study. The late results of open-window corpectomy (OWC) were documented in a group of patients.

SUMMARY OF BACKGROUND DATA: The aim of this study was to assess long-term clinical and radiologic outcomes after OWC in patients with advanced cervical spondylosis and/or OPLL.

METHODS: Data were collected from 15 patients at 3 time points: preoperatively and at 15 months and 92 months postoperatively. The clinical parameters were pain (assessed by visual analog scale) and upper extremity function (assessed by Japanese Orthopedics Association) score. The radiologic parameters recorded from magnetic resonance imaging and computed tomography were lordosis angles (cervical and segmental) and cervical spinal canal diameter. Group means were calculated and findings at the 3 time points were statistically compared. Adjacent-segment degeneration was also evaluated at 92 months.

RESULTS: Concerning visual analog scale and Japanese Orthopedics Association results, the 2 postoperative mean scores were both significantly better than the preoperative mean but were not statistically different. The postoperative mean results for cervical and segmental lordosis angles and spinal canal diameter were all significantly better than the respective preoperative means for these parameters. Comparisons of postoperative means revealed no significant change in cervical lordosis, segmental lordosis, or cervical spinal canal diameter from short-term to long-term follow-ups. Five patients showed mild degeneration at adjacent segments in long-term follow-up.

CONCLUSIONS: Long-term follow-up indicates that OWC yields satisfactory clinical and radiologic outcomes in patients with anterior compressive cervical spondylosis and/or OPLL. OWC technique creates a more stable construct with 3-point fixation and offers better load sharing among implants and healthy vertebrae. Our observations suggest that OWC is a good surgical option for this patient group.

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