Analysis of the Incompletely Hoisted Vertebrae in the Anterior Controllable Antedisplacement and Fusion Surgery: Causes and Prevention
Abstract
PURPOSE: Anterior controllable antedisplacement and fusion (ACAF) has been reported to be a safe and effective technique. However, incompletely hoisted vertebrae (IV) were found in the postoperative images. This study aims to analyze the causes and prevention of IV.
METHODS: The ACAF-treated case series subjects were retrospectively reviewed. The vertebrae were separated into the IV group and completely hoisted vertebrae (CV) group according to the gap between the vertebrae and plate. The radiographic data, degree of cervical lordosis, bone mineral density, number of hoisted vertebrae, operative time, blood loss, and Japanese Orthopaedic Association score were compared between the patients with IV and the patients without IV.
RESULTS: A total of 248 vertebrae were hoisted in the enrolled patients. Intervertebral disc height in the IV group was 3.7±0.4 mm, which is significantly lower than that in the CV group. The anterior or posterior overhanging lip, osteoporosis, and oblique osteotomy troughs and hinges existing after osteotomy were found to be impingements preventing the hoisting of the vertebrae. There were no differences in the age, sex, degree of cervical lordosis, number of hoisted vertebrae, and neurological improvement rate between the groups of patients with and without IV.
CONCLUSIONS: Lower intervertebral space height and impingements preventing hoisting were found to be possible causes of IV in ACAF. Measures to prevent the problem should be carried out.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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