{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:26:59Z","timestamp":1760711219999,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) represent effective alternatives in the management of multilevel cervical spondylotic myelopathy (CSM). A consensus on which of these techniques should be used is still missing. Methods: The databases of three centers were reviewed (January 2011\u2013December 2018) for patients with three-level CSM, who underwent three-level ACDF without plating or two-level ACCF with expandable cage (VBRC) or mesh (VBRM). Demographic data, surgical strategy, complications, and implant failure were analyzed. The Neck Disability Index (NDI), the Visual Analog Scale (VAS), and the cervical lordosis were compared between the two techniques at 3 and 12 months. Logistic regression analyses investigated independent factors influencing clinical and radiological outcomes. Results: Twenty-one and twenty-two patients were included in the ACDF and ACCF groups, respectively. The median follow-up was 18 months. ACDFs were associated with better clinical outcomes at 12 months (NDI: 8.3% vs. 19.3%, p &lt; 0.001; VAS: 1.3 vs. 2.6, p = 0.004), but with an increased risk of loss of lordosis correction \u2265 1\u00b0 (OR = 4.5; p = 0.05). A higher complication rate in the ACDF group (33.3% vs. 9.1%; p = 0.05) was recorded, but it negatively influenced only short-term clinical outcomes. ACCFs with VBRC were associated with a higher risk of major complications but ensured better 12-month lordosis correction (p = 0.002). No significant differences in intraoperative blood loss were noted. Conclusions: Three-level ACDF without plating was associated with better clinical outcomes than two-level ACCF despite worse losses in lordosis correction, which is ideal for fragile patients without retrovertebral compressions. In multilevel CSM, the relationship between the degree of lordosis correction and clinical outcome advantages still needs to be investigated.<\/jats:p>","DOI":"10.3390\/life13071564","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T08:35:47Z","timestamp":1689323747000},"page":"1564","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Two-Level Corpectomy and Fusion vs. Three-Level Anterior Cervical Discectomy and Fusion without Plating: Long-Term Clinical and Radiological Outcomes in a Multicentric Retrospective Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5874-7340","authenticated-orcid":false,"given":"Giorgio","family":"Lofrese","sequence":"first","affiliation":[{"name":"Neurosurgery Unit, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5087-6006","authenticated-orcid":false,"given":"Sokol","family":"Trungu","sequence":"additional","affiliation":[{"name":"NESMOS Department, \u201cSapienza\u201d University of Rome, Sant\u2019Andrea Hospital, 00185 Rome, Italy"},{"name":"Neurosurgery Unit, Cardinale G. Panico Hospital, 73039 Tricase, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8607-5323","authenticated-orcid":false,"given":"Alba","family":"Scerrati","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, S. Anna University Hospital, 44124 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9879-8940","authenticated-orcid":false,"given":"Pasquale","family":"De Bonis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, S. Anna University Hospital, 44124 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Cultrera","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Mongardi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, S. Anna University Hospital, 44124 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-8907","authenticated-orcid":false,"given":"Nicola","family":"Montemurro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5360-5810","authenticated-orcid":false,"given":"Amedeo","family":"Piazza","sequence":"additional","affiliation":[{"name":"NESMOS Department, \u201cSapienza\u201d University of Rome, Sant\u2019Andrea Hospital, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Miscusi","sequence":"additional","affiliation":[{"name":"NESMOS Department, \u201cSapienza\u201d University of Rome, Sant\u2019Andrea Hospital, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigino","family":"Tosatto","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Raco","sequence":"additional","affiliation":[{"name":"NESMOS Department, \u201cSapienza\u201d University of Rome, Sant\u2019Andrea Hospital, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5110-8386","authenticated-orcid":false,"given":"Luca","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"NESMOS Department, \u201cSapienza\u201d University of Rome, Sant\u2019Andrea Hospital, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.2106\/JBJS.F.00014","article-title":"Operative treatment of cervical spondylotic myelopathy","volume":"88","author":"Rao","year":"2006","journal-title":"J. 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