P24. Prospective multicenter anterior cervical discectomy and fusion outcome study utilizing a new semi-constrained cervical plate

Abstract This surgical video demonstrates the technique for correcting degenerative cervical kyphosis using an anterior cervical discectomy and fusion (ACDF). Degenerative cervical kyphosis can cause radiculopathy, myelopathy, and difficulty holding up one's head. The goal of surgical intervention is to alleviate pain, improve the ability for upright gaze, and decompress the spinal cord or nerve roots. Posterior-only approaches and anterior corpectomies are alternative treatments to address cervical kyphosis. However, an ACDF allows for sequential induction of lordosis via distraction over multiple segments and for further lordosis induction by sequential screw tightening, pulling the spine towards a lordotic cervical plate.1 This video shows 2 cases demonstrating a technique of correcting severe cervical degenerative kyphosis. The video illustrates our initial kyphotic Caspar pin placement coupled with sequential anterior distraction to correct kyphosis. The technique is most useful in patients who have good bone density, nonankylosed facets, and degenerative cervical kyphosis. We have received informed consent of this patient to submit this video.

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Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation?

Journal of Neurosurgery Spine ◽

10.3171/2013.7.spine13208 ◽

2013 ◽

Vol 19 (5) ◽

pp. 527-531 ◽

Cited By ~ 23

Author(s):

Myles Luszczyk ◽

Justin S. Smith ◽

Jeffrey S. Fischgrund ◽

Steven C. Ludwig ◽

Rick C. Sasso ◽

...

Keyword(s):

Plate Fixation ◽

Fusion Rate ◽

Anterior Cervical Discectomy ◽

Cervical Disc ◽

Cervical Discectomy ◽

Single Level ◽

Significant Difference ◽

Solid Fusion ◽

Cervical Plate ◽

Anterior Cervical Plate

Object Although smoking has been shown to negatively affect fusion rates in patients undergoing multilevel fusions of the cervical and lumbar spine, the effect of smoking on fusion rates in patients undergoing single-level anterior cervical discectomy and fusion (ACDF) with allograft and plate fixation has yet to be thoroughly investigated. The objective of the present study was to address the effect of smoking on fusion rates in patients undergoing a 1-level ACDF with allograft and a locked anterior cervical plate. Methods This study is composed of patients from the control groups of 5 separate studies evaluating the use of an anterior cervical disc replacement to treat cervical radiculopathy. For each of the 5 studies the control group consisted of patients who underwent a 1-level ACDF with allograft and a locked cervical plate. The authors of the present study reviewed data obtained in a total of 573 patients; 156 patients were smokers and 417 were nonsmokers. A minimum follow-up period of 24 months was required for inclusion in this study. Fusion status was assessed by independent observers using lateral, neutral, and flexion/extension radiographs. Results An overall fusion rate of 91.4% was achieved in all 573 patients. A solid fusion was shown in 382 patients (91.6%) who were nonsmokers. Among patients who were smokers, 142 (91.0%) had radiographic evidence of a solid fusion. A 2-tailed Fisher exact test revealed a p value of 0.867, indicating no difference in the union rates between smokers and nonsmokers. Conclusions The authors found no statistically significant difference in fusion status between smokers and nonsmokers who underwent a single-level ACDF with allograft and a locked anterior cervical plate. Although the authors do not promote tobacco use, it appears that the use of allograft with a locked cervical plate in single-level ACDF among smokers produces similar fusion rates as it does in their nonsmoking counterparts.

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Anterior Cervical Discectomy and Fusion (ACDF): Comparison Between Zero Profile Implants and Anterior Cervical Plate and Spacer

Cureus ◽

10.7759/cureus.573 ◽

2016 ◽

Cited By ~ 3

Author(s):

Marjan Alimi ◽

Innocent Njoku ◽

Christoph P Hofstetter ◽

Apostolos J Tsiouris ◽

Kartik Kesavabhotla ◽

...

Keyword(s):

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Cervical Plate ◽

Anterior Cervical Plate

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The influence of cervical plate fixation with either autologous bone or cage insertion on radiographic and patient-rated outcomes after two-level anterior cervical discectomy and fusion

European Spine Journal ◽

10.1007/s00586-014-3456-y ◽

2014 ◽

Vol 24 (1) ◽

pp. 113-119 ◽

Cited By ~ 11

Author(s):

Jan-Karl Burkhardt ◽

Anne F. Mannion ◽

Serge Marbacher ◽

Frank S. Kleinstück ◽

Dezsö Jeszenszky ◽

...

Keyword(s):

Plate Fixation ◽

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Autologous Bone ◽

Cervical Plate

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Anterior Cervical Discectomy (ACD) Versus Anterior Cervical Fusion (ACF), Clinical and Radiological Outcome Study

Acta Neurochirurgica ◽

10.1007/s007010050487 ◽

1999 ◽

Vol 141 (10) ◽

pp. 1089-1092 ◽

Cited By ~ 50

Author(s):

N. Abd-Alrahman ◽

A. S. Dokmak ◽

A. Abou-Madawi

Keyword(s):

Anterior Cervical Fusion ◽

Anterior Cervical Discectomy ◽

Outcome Study ◽

Cervical Fusion ◽

Radiological Outcome ◽

Cervical Discectomy ◽

Clinical And Radiological Outcome

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Functional outcome of anterior cervical discectomy and fusion with anterior cervical plate in cervical disc herniation

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2021.v7.i2g.2674 ◽

2021 ◽

Vol 7 (2) ◽

pp. 530-539

Author(s):

Dr. TH Prakashappa ◽

Dr. Mohan NS ◽

Dr. Siddesh Patil ◽

Dr. Arjun Kumar V

Keyword(s):

Functional Outcome ◽

Disc Herniation ◽

Anterior Cervical Discectomy ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Cervical Discectomy ◽

Cervical Plate ◽

Anterior Cervical Plate

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Comparative study of anterior cervical discectomy and fusion by anterior cervical plate and stand-alone cervical cage

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203540 ◽

2020 ◽

Vol 6 (5) ◽

pp. 888

Author(s):

Ansari Muqtadeer Abdul Aziz ◽

Venktesh Dattatray Sonkawade ◽

Ansari Ishtyaque Abdul Aziz ◽

Nair Pradeepkumar Sasidharan

Keyword(s):

Cervical Spine ◽

Intraoperative Complications ◽

Anterior Cervical Discectomy ◽

Research Centre ◽

Cervical Disc ◽

Cervical Discectomy ◽

Single Level ◽

Incision Size ◽

Cervical Plate ◽

Anterior Cervical Plate

Background: Anterior cervical discectomy (ACD) was used for management of degenerative cervical disc disorders (DCDD) in previous days. Further research and developments in management of DCDD led to evolution of standard and widely used operative technique as anterior cervical discectomy and fusion (ACDF) by either anterior cervical plate (ACDF-ACP) with bone grafting or stand-alone cage (ACDF-SAC). There is less data available in literature regarding when and where to use ACDF-ACP and ACDF-SAC.Methods: The study was conducted on 20 patients operated in Government Medical College and Hospital and Pacific Hospital and Research Centre, Aurangabad from June 2018 to March 2020. These patients divided into group A - 10 patients, operated by ACDF-SAC which are further divided as group Aa - 6 patients - operated for single level ACDF-SAC and group Ab - 4 patients - operated for two level ACDF-SAC, group B - 10 patients, operated by ACDF-ACP which are further divided as group Ba - 5 patients - operated for single level ACDF-ACP and group Bb - 5 patients - operated for two level ACDF-ACP. Patients evaluated preoperatively and postoperatively using X-ray cervical spine anteroposterior (AP) and lateral views, MRI cervical spine, visual analogue scale (VAS) for pain, Robinson’s criteria and Cobb’s angle.Results: In our study we found, ACDF-SAC has small incision size, less intraoperative time, easy to carry out for surgeons, less intraoperative complications and better clinical outcome as compared to ACDF-ACP. Whereas only radiological results were better in ACDF-ACP than ACDF-SAC.Conclusions: ACDF-SAC is superior to ACDF-ACP for appropriately selected patients and in well experienced hands.

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