Complication Profiles of Corpectomy-Containing Versus Non-Corpectomy Anterior Cervical Surgery for Degenerative Cervical Myelopathy

This retrospective multicenter study from Japan compared complication rates in 1,024 patients who had anterior cervical surgery for degenerative cervical myelopathy, dividing them into non-corpectomy procedures (like ACDF, n=617) and corpectomy-containing procedures (ACCF or hybrid, n=407). Corpectomy patients had longer surgeries, more blood loss, and much higher unadjusted complication rates (perioperative local complications 38.1% vs 16.5%, dural injury 17.4% vs 1.5%), but after adjusting for OPLL and surgical extent, the independent association between corpectomy itself and complications largely disappeared (OR dropped from 1.82 to 1.12, no longer significant).

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersHelps spine surgeons understand that the higher complication burden they see with corpectomy is mostly driven by disease severity (OPLL, multilevel disease) rather than the corpectomy technique itself, which matters for counseling and risk stratification.

Presenting this at rounds? Start here

• ?Given the retrospective design and unmeasured confounders like canal-occupying ratio, K-line status, and dural ossification, how much residual confounding could still be driving the observed complication differences even after multivariable adjustment?
• ?If corpectomy itself is not independently associated with complications once surgical extent is accounted for, should surgeons feel more comfortable choosing corpectomy when it offers a decompression advantage, or does the crude complication rate still matter for informed consent?