Spine · IF 2.6 · July 20, 2026 · LoE II
Complication Profiles of Corpectomy-Containing Versus Non-Corpectomy Anterior Cervical Surgery for Degenerative Cervical Myelopathy
Takashi Hirai, Kenichiro Sakai, Hiroaki Onuma, Motonori Hashimoto, Akihiro Horiuchi, Hiroyuki Inose, Kentaro Yamada, Yu Matsukura, Shingo Morishita, Satoru Egawa, Atsuyuki Kawabata, Takuya Takahashi — Tokyo Medical and Dental University
This retrospective study from three Japanese spine centers compared complication rates between 407 patients who had corpectomy-containing anterior cervical surgery (ACCF or hybrid ACDF/ACCF) and 617 patients who had non-corpectomy anterior surgery (mostly ACDF) for degenerative cervical myelopathy. Corpectomy patients had far more perioperative local complications (38.1% vs 16.5%), dural injury (17.4% vs 1.5%), reoperation (9.8% vs 2.4%), and upper-extremity weakness (13.0% vs 4.2%), but after adjusting for how many levels were operated and whether the upper cervical spine was involved, the extra risk from corpectomy itself largely disappeared (adjusted OR fell from 1.82 to 1.12, no longer significant). The authors conclude that much of the added morbidity reflects the underlying OPLL pathology and greater surgical extent rather than corpectomy as a technique per se.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersHelps residents and spine surgeons frame corpectomy's higher complication burden as a marker of surgical complexity and OPLL severity rather than an independent reason to avoid the procedure, which matters for informed consent and case selection.
Conclusion strengthConfirms prior evidence
Patient-important outcome and fragility index 96, offset by no power calculation.
Presenting this at rounds? Start here
- ?Because the choice between corpectomy and non-corpectomy surgery was driven by pathology severity and surgeon judgment rather than randomization, how confident can we be that adjusting for operated levels and upper cervical involvement fully removes confounding by indication, especially since important variables like canal-occupying ratio, K-line status, and dural ossification were not modeled?
- ?When counseling a patient with massive, dura-adherent OPLL who may need corpectomy for adequate decompression, how should this data on higher dural injury, reoperation, and airway complication rates be weighed against the potential neurological benefit of more complete anterior decompression?