{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:03:41Z","timestamp":1785884621137,"version":"3.56.0"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Vertebral body sliding osteotomy (VBSO) is a surgical technique that anteriorly translates the vertebral body with compressive lesions and achieves cord decompression through canal widening. However, data on the surgical complications of VBSO are lacking. Furthermore, it has not been known whether VBSO could be a viable alternative in the treatment of cervical myelopathy even when the preoperative canal-occupying ratio (COR) is large, which seems to frequently result in incomplete canal widening. This study aimed to describe the incidence of VBSO-associated surgical complications and to evaluate the incidence and risk factors of incomplete canal widening.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A total of 109 patients who underwent VBSO to treat cervical myelopathy were retrospectively reviewed. Neck pain visual analog scale, Neck Disability Index, Japanese Orthopaedic Association (JOA) scores, and surgical complications were evaluated. For radiological evaluation, C2\u20137 lordosis, C2\u20137 sagittal vertical axis, and COR were measured. Patients with a preoperative COR &lt; 50% (n = 60) and those with a COR \u2265 50% (n = 49) were compared and logistic regression analysis was performed to identify factors associated with incomplete canal widening.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The most frequent complication in the patients was mild dysphagia (7.3%). Dural tears were observed during posterior longitudinal ligament resection (n = 1) and foraminotomy (n = 1). Two patients underwent reoperation due to radiculopathy from adjacent-segment disease. Incomplete canal widening occurred in 49 patients. According to logistic regression analysis, high preoperative COR was the only factor associated with incomplete canal widening. The amount of canal widening and JOA recovery rate in the COR \u2265 50% group were significantly higher than in the COR &lt; 50% group.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Mild dysphagia was the most common complication following VBSO. Although VBSO aims to decrease the complication rate of corpectomy, it was not free of dural tears. Special care would be required during the posterior longitudinal ligament resection. Incomplete canal widening occurred in 45.0% of patients, and high preoperative COR was the only risk factor for incomplete canal widening. However, high preoperative COR would not be a contraindication for VBSO, given that favorable clinical outcomes were presented in the COR \u2265 50% group.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.5.spine23287","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T23:04:52Z","timestamp":1687647892000},"page":"520-526","source":"Crossref","is-referenced-by-count":5,"title":["Surgical complications and incomplete canal widening of the vertebral body sliding osteotomy to treat cervical myelopathy"],"prefix":"10.3171","volume":"39","author":[{"given":"Dong-Ho","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Tan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Ilsan Paik Hospital, University of Inje College of Medicine, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehan","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Ju","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hwan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Ilsan Paik Hospital, University of Inje College of Medicine, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"J Am Acad Orthop Surg","first-page":"332","article-title":"Safety and efficacy of a novel anterior decompression technique for ossification of posterior longitudinal ligament of the cervical spine","volume":"28","author":"Lee DH","year":"2020","unstructured":"Lee DH, Riew KD, Choi SH,  Safety and efficacy of a novel anterior decompression technique for ossification of posterior longitudinal ligament of the cervical spine. J Am Acad Orthop Surg. 2020;28(8):332\u2013341."},{"issue":"6","key":"b2","series-title":"Global Spine J","first-page":"1074","article-title":"Significance of vertebral body sliding osteotomy as a surgical strategy for the treatment of cervical ossification of the posterior longitudinal ligament","volume":"12","author":"Lee DH","year":"2022","unstructured":"Lee DH, Park S, Hong CG,  Significance of vertebral body sliding osteotomy as a surgical strategy for the treatment of cervical ossification of the posterior longitudinal ligament. Global Spine J. 2022;12(6):1074\u20131083."},{"issue":"6","key":"b3","series-title":"Spine J","first-page":"1099","article-title":"A novel anterior decompression technique (vertebral body sliding osteotomy) for ossification of posterior longitudinal ligament of the cervical spine","volume":"18","author":"Lee DH","year":"2018","unstructured":"Lee DH, Cho JH, Lee CS, Hwang CJ, Choi SH, Hong CG. A novel anterior decompression technique (vertebral body sliding osteotomy) for ossification of posterior longitudinal ligament of the cervical spine. Spine J. 2018;18(6):1099\u20131105."},{"issue":"3","key":"b4","series-title":"J Neurosurg Spine","first-page":"307","article-title":"Improvement in cervical lordosis and sagittal alignment after vertebral body sliding osteotomy in patients with cervical spondylotic myelopathy and kyphosis","volume":"33","author":"Lee DH","year":"2020","unstructured":"Lee DH, Lee CS, Hwang CJ, Cho JH, Park JW, Park KB. Improvement in cervical lordosis and sagittal alignment after vertebral body sliding osteotomy in patients with cervical spondylotic myelopathy and kyphosis. J Neurosurg Spine. 2020;33(3):307\u2013315."},{"issue":"3","key":"b5","series-title":"Neurospine","first-page":"640","article-title":"Vertebral body sliding osteotomy for cervical myelopathy with rigid kyphosis","volume":"17","author":"Lee DH","year":"2020","unstructured":"Lee DH, Park S, Lee WS,  Vertebral body sliding osteotomy for cervical myelopathy with rigid kyphosis. Neurospine. 2020;17(3):640\u2013647."},{"issue":"7","key":"b6","series-title":"Spine J","first-page":"1089","article-title":"Fusion and subsidence rates of vertebral body sliding osteotomy: comparison of 3 reconstructive techniques for multilevel cervical myelopathy","volume":"21","author":"Lee DH","year":"2021","unstructured":"Lee DH, Park S, Hong CG,  Fusion and subsidence rates of vertebral body sliding osteotomy: comparison of 3 reconstructive techniques for multilevel cervical myelopathy. Spine J. 2021;21(7):1089\u20131098."},{"key":"b7","series-title":"Med Sci Monit","first-page":"6398","article-title":"Anterior cervical corpectomy and fusion and anterior cervical discectomy and fusion using titanium mesh cages for treatment of degenerative cervical pathologies: a literature review","volume":"24","author":"Wen Z","year":"2018","unstructured":"Wen Z, Lu T, Wang Y, Liang H, Gao Z, He X. Anterior cervical corpectomy and fusion and anterior cervical discectomy and fusion using titanium mesh cages for treatment of degenerative cervical pathologies: a literature review. Med Sci Monit. 2018;24:6398\u20136404."},{"issue":"3","key":"b8","series-title":"Curr Rev Musculoskelet Med","first-page":"263","article-title":"Degenerative cervical myelopathy","volume":"9","author":"Kato S","year":"2016","unstructured":"Kato S, Fehlings M. Degenerative cervical myelopathy. Curr Rev Musculoskelet Med. 2016;9(3):263\u2013271."},{"issue":"4","key":"b9","series-title":"Spine (Phila Pa 1976)","first-page":"354","article-title":"Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament","volume":"6","author":"Hirabayashi K","year":"1981","unstructured":"Hirabayashi K, Miyakawa J, Satomi K, Maruyama T, Wakano K. Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine (Phila Pa 1976). 1981;6(4):354\u2013364."},{"issue":"3","key":"b10","series-title":"Neurospine","first-page":"517","article-title":"Ossification of the posterior longitudinal ligament: surgical approaches and associated complications","volume":"16","author":"Head J","year":"2019","unstructured":"Head J, Rymarczuk G, Stricsek G,  Ossification of the posterior longitudinal ligament: surgical approaches and associated complications. Neurospine. 2019;16(3):517\u2013529."},{"issue":"5","key":"b11","series-title":"Spine (Phila Pa 1976)","first-page":"E309","article-title":"Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history","volume":"37","author":"Matsunaga S","year":"2012","unstructured":"Matsunaga S, Sakou T. Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history. Spine (Phila Pa 1976). 2012;37(5):E309\u2013E314."},{"issue":"1","key":"b12","series-title":"Indian J Orthop","first-page":"92","article-title":"Cervical ossification of the posterior longitudinal ligament: anterior versus posterior approach","volume":"46","author":"Lin D","year":"2012","unstructured":"Lin D, Ding Z, Lian K, Hong J, Zhai W. Cervical ossification of the posterior longitudinal ligament: anterior versus posterior approach. Indian J Orthop. 2012;46(1):92\u201398."},{"issue":"1","key":"b13","series-title":"Spine (Phila Pa 1976)","first-page":"58","article-title":"Long-term results of cervical myelopathy due to ossification of the posterior longitudinal ligament with an occupying ratio of 60% or more","volume":"39","author":"Fujimori T","year":"2014","unstructured":"Fujimori T, Iwasaki M, Okuda S,  Long-term results of cervical myelopathy due to ossification of the posterior longitudinal ligament with an occupying ratio of 60% or more. Spine (Phila Pa 1976). 2014;39(1):58\u201367."},{"issue":"26","key":"b14","series-title":"Spine (Phila Pa 1976)","first-page":"2143","article-title":"The revision rate and occurrence of adjacent segment disease after anterior cervical discectomy and fusion: a study of 672 consecutive patients","volume":"39","author":"van Eck CF","year":"2014","unstructured":"van Eck CF, Regan C, Donaldson WF, Kang JD, Lee JY. The revision rate and occurrence of adjacent segment disease after anterior cervical discectomy and fusion: a study of 672 consecutive patients. Spine (Phila Pa 1976). 2014;39(26):2143\u20132147."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/4\/article-p520.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/4\/article-p520.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/4\/article-p520.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:14:29Z","timestamp":1733490869000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/4\/article-p520.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,1]]},"references-count":14,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2023.5.spine23287","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2023,10,1]]}}}