ArticleZhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences2026
[Clinical efficacy of anterior cervical mortise-tenon corpectomy and fusion for the treatment of ossification of the posterior longitudinal ligament].
Article in Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesFor the segmental ossification of cervical posterior longitudinal ligament (OPLL) accompanied by spinal cord compression, anterior cervical corpectomy and fusion (ACCF) can achieve direct decompression through removal of most of the involved vertebral body. However, reconstruction-related complications such as titanium mesh cage subsidence, loss of cervical lordosis, and poor bone fusion are common after surgery. This study aims to investigate the clinical efficacy of a novel anterior cervical mortise-tenon corpectomy and fusion (ACMTF) technique, designed based on principles of biological reconstruction and traditional structural mechanics, for the treatment of segmental cervical OPLL, and to compare its outcomes with those of conventional ACCF.
methodsA retrospective analysis was conducted on patients with segmental cervical OPLL who underwent anterior surgery in the Department of Spinal Surgery, Xiangya Hospital, Central South University, between January 2020 and May 2024. Among them, 30 patients underwent ACMTF (ACMTF group). Using propensity score matching at a 1꞉1 ratio, 30 patients who underwent conventional ACCF during the same period were selected as controls (ACCF group). In the ACMTF group, an ultrasonic osteotome was used to perform V-shaped osteotomy of the anterior vertebral body. After removal of the posterior ossified lesion, the V-shaped autologous bone block was restored in situ to form a mortise-tenon structure and fixed with an intervertebral fusion cage and anterior titanium plate. The ACCF group underwent conventional subtotal corpectomy and titanium mesh reconstruction. Surgical time, intraoperative blood loss, perioperative and follow-up complications, and Japanese Orthopaedic Association (JOA) score, JOA recovery rate, Neck Disability Index (NDI), and Visual Analogue Scale (VAS) score at different follow-up time points before and after surgery were compared between the two groups. Imaging examinations were used to evaluate and compare occupation ratio (OR), space available for the spinal cord (SAC), fusion rate, implant subsidence rate, and changes in cervical lordosis angle.
resultsAfter propensity score matching, there were no statistically significant differences between the 2 groups in baseline characteristics including sex, age, disease duration, body mass index, and surgical segments (all
conclusionsACMTF for segmental cervical OPLL can achieve neurological decompression, neurological recovery, and pain relief comparable to those of ACCF. The in situ restoration design of the autologous bone block based on the mortise-tenon principle enables stable mechanical interlocking at the surgical site, effectively prevents severe graft subsidence, better maintains physiological cervical curvature, and achieves reliable bony fusion. Therefore, ACMTF represents a safe and effective anterior biological reconstruction strategy for the treatment of segmental cervical OPLL.
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