Anterior cervical X-shape-corpectomy and fusion vs. anterior cervical corpectomy and fusion for two-level cervical spondylosis

Abstract Purpose 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. Methods 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. Results 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. Conclusions 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.