Objective This retrospective cohort study has been aimed at evaluating the incidence of complications after vertebral body sliding osteotomy (VBSO) and analyzing some cases. Furthermore, the complications of VBSO were compared with those of anterior cervical corpectomy and fusion (ACCF).
Methods This study included 154 patients who underwent VBSO (n = 109) or ACCF (n = 45) for cervical myelopathy and were followed up for > 2 years. Surgical complications, clinical and radiological outcomes were analyzed.
Results The most common surgical complications after VBSO were dysphagia (n = 8, 7.3%) and significant subsidence (n = 6, 5.5%). There were 5 cases of C5 palsy (4.6%), followed by dysphonia (n = 4, 3.7%), implant failure (n = 3, 2.8%), pseudoarthrosis (n = 3, 2.8%), dural tears (n = 2, 1.8%), and reoperation (n = 2, 1.8%). C5 palsy and dysphagia did not require additional treatment and spontaneously resolved. The rates of reoperation (VBSO, 1.8%; ACCF, 11.1%; p = 0.02) and subsidence (VBSO, 5.5%; ACCF, 40%; p < 0.01) were significantly lower in VBSO than in ACCF. VBSO restored more C2–7 lordosis (VBSO, 13.9° ± 7.5°; ACCF, 10.1° ± 8.0°; p = 0.02) and segmental lordosis (VBSO, 15.7° ± 7.1°; ACCF, 6.6° ± 10.2°; p < 0.01) than ACCF. The clinical outcomes did not significantly differ between both groups.
Conclusion VBSO has advantages over ACCF in terms of low rate of surgical complications related to reoperation and significant subsidence. However, dural tears may still occur despite the lessened need for ossified posterior longitudinal ligament lesion manipulation in VBSO; hence, caution is warranted.
Citations
Citations to this article as recorded by
Comparative efficacy and safety of ACAF, ACCF, and laminoplasty for multilevel cervical OPLL: A network meta-analysis of observational studies Wei Wang, Cheng-Hao Xiang, Dan Li, Xian-Zao Wang, Xin-Hua Xu Journal of Orthopaedic Surgery.2026;[Epub] CrossRef
The number of fusion levels as a potential factor influencing long-term complications of anterior controllable antedisplacement fusion: a biomechanical analysis Gaole He, Haopeng Li, Liang Yan, Zhongkai Liu, Teng Lu Frontiers in Surgery.2026;[Epub] CrossRef
Vertebral body sliding osteotomy as a less invasive alternative to 540° surgery for cervical myelopathy with rigid kyphosis Dong-Ho Lee, Sung Tan Cho, Chang Ju Hwang, Jae Hwan Cho, Sehan Park, Jin Hwan Kim, Wongthawat Liawrungrueang European Spine Journal.2026;[Epub] CrossRef
Anterior Controllable Antedisplacement Fusion (ACAF) in Revision Surgery for Iatrogenic Cervical Kyphosis: Technical Note and Case Series Zhenlei Liu, Yaobin Wang, Lei Zhang, Shanhang Jia, He Wang, Lei Cheng, Fengzeng Jian, Kai Wang, Hao Wu Orthopaedic Surgery.2025; 17(4): 1265. CrossRef
Novel radiologic parameter for assessing decompression adequacy in anterior cervical decompression surgery: the V-line Dong-Ho Lee, Sung Tan Cho, Chang Ju Hwang, Jae Hwan Cho, Sehan Park, Jin Hwan Kim, Wongthawat Liawrungrueang The Spine Journal.2025; 25(9): 1928. CrossRef
A narrative review of surgical approaches in cervical degenerative myelopathy and update of the algorithm for decision making Majid Reza Farrokhi, Seyed Reza Mousavi, Abbas Khosravifarsani, Jaloliddin Mavlonov, Mohammadhadi Amir Shahpari Motlagh, Seyed Bahram Seif, Armin Akbarzadeh Egyptian Journal of Neurosurgery.2025;[Epub] CrossRef
Management of Cerebrospinal Fluid Leakage by Pump-Regulated Volumetric Continuous Lumbar Drainage Following Anterior Cervical Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament Sun Woo Jang, Sang Hyub Lee, Hong Kyung Shin, Sang Ryong Jeon, Sung Woo Roh, Jin Hoon Park Neurospine.2023; 20(4): 1421. CrossRef
First
Prev
