Comparative Analysis between Vertebral Body Sliding Osteotomy and Anterior Cervical Corpectomy with Fusion for Cervical Spinal Ossification of Posterior Longitudinal Ligament.

This retrospective study compared the clinical and radiographic outcomes of vertebral body sliding osteotomy (n = 26) and anterior cervical corpectomy with fusion (n = 17) in 43 patients with K-line negative cervical ossification of the posterior longitudinal ligament. Clinical and radiographic parameters were evaluated preoperatively, postoperatively, and at the final follow-up. Within this cohort, the vertebral body sliding osteotomy group was associated with shorter hospital stays (p < 0.001) and greater postoperative Visual Analog Scale improvement (p = 0.048). While the anterior cervical corpectomy with fusion group achieved significantly larger immediate postoperative segmental lordosis correction, no significant difference was observed between groups in the long-term maintenance of overall segmental alignment. However, subgroup analysis suggested that in patients experiencing postoperative kyphotic progression, vertebral body sliding osteotomy was associated with less subsequent loss of segmental lordosis correction compared to anterior cervical corpectomy with fusion (p = 0.021). Both techniques effectively achieved decompression for K-line negative ossification of the posterior longitudinal ligament, with similar safety profiles and equivalent fusion rates. These preliminary findings suggest that vertebral body sliding osteotomy may be considered a potentially viable alternative to anterior cervical corpectomy with fusion, offering comparable outcomes and potential merits in early recovery and alignment maintenance for select patients.