Clinical significance of microsurgical excision of the posterior longitudinal ligament using a high-frequency electrosurgical excision procedure in anterior cervical discectomy and fusion.

Abstract

IntroductionAnterior cervical decompression and fusion surgery using traditional methods to remove the posterior longitudinal ligament often causes massive bleeding, increasing the risk of surgery. However, the use of a high-frequency electrotome under the microscope can significantly reduce bleeding and reduce the risk of surgery.AimTo explore the clinical significance of electrosurgical excision of the posterior longitudinal ligament in the cervical anterior approach under the microscope.Material and methodsFrom December 2015 to December 2017, patients who underwent anterior cervical discectomy and fusion at our hospital were followed up. We enrolled 73 men and 50 women who were 30 to 74 years old (mean, 49.96 years). Among 67 patients in group A treated with a high-frequency electrosurgical knife under the microscope, 58 were followed up; among 73 patients in group B treated with a traditional cervical hook knife under the microscope, 65 were followed up. Clinical data, operative time, intraoperative bleeding volume, VAS score, and Japanese Orthopaedic Association (JOA) improvement rate were retrospectively analyzed.ResultsThere were significant differences in the mean operative time and intraoperative bleeding volume between the two groups (p < 0.05); however, no significant differences were found in the incidence of cerebrospinal fluid leakage, JOA improvement rate at 3 months postoperatively, and VAS score at 3 months postoperatively between the two groups (p > 0.05).ConclusionsElectrosurgical resection of the posterior longitudinal ligament of the cervical vertebrae under the microscope can significantly reduce intraoperative bleeding and shorten the operative time and has obvious advantages compared with traditional methods.