Safety of Anterior Cervical Corpectomy and Fusion (ACCF) for the Treatment of Subaxial Cervical Spine Injuries: a Single Center Comparative Matched Analysis.

Introduction: Anterior Cervical Discectomy and Fusion (ACDF) and Anterior Cervical Corpectomy and Fusion (ACCF) are common surgical procedures in managing pathologies of the subaxial cervical spine. While recent reviews have demonstrated ACCF to provide better decompression results than ACDF, the procedure has been associated with increased surgical risks. Nonetheless, the use of ACCF in a traumatic context has been poorly described. This study aimed to assess the safety of ACCF compared to the more commonly performed ACDF.

Methods: All patients undergoing ACCF or ACDF for subaxial cervical spine injuries spanning two disc spaces and 3 vertebral levels at the study center between 2006 and 2018 were eligible for inclusion. Patients were matched based on age and preoperative ASIA score.

Results: After matching, 60 patients were included in the matched analysis, where 30 underwent ACDF and ACCF, respectively. Vertebral body injury was significantly more common in the ACCF group (p=0.002), while traumatic disc rupture was more frequent in the ACDF group (p=0.032). There were no statistically significant differences in the rates of surgical complications, including implant failure, wound infection, dysphagia, and CSF leakage between the groups (p≥0.05). The rates of revision surgeries (p>0.999), mortality (p=0.222), and long-term ASIA scores (p=0.081) were also similar.

Conclusion : Results of both unmatched and matched analyses indicate that ACCF has comparable outcomes and no additional risks compared to ACDF. It is thus a safe approach and should be considered for patients with extensive anterior column injury.