ANTERIOR CERVICAL DISCECTOMY
Anterior cervical discectomy and fusion (ACDF) with anterior plate fixation is an established surgical treatment for patients with cervical disc disease. The video demonstrates the operative technique of an ACDF with anterior cervical plate fixation utilizing the PEAK polyaxial plate-screw system. A case is presented, detailing history, clinical manifestations, radiographic findings, operative course, and postoperative outcome.
The Cervical Spine in India
The human spine is divided into three sections : –
- the cervical spine or neck (which is made up of 7 vertebrae)
- the thoracic spine (which is made up of 12 vertebrae)
- the lumbar spine or low back (which consists of 5 vertebrae)
The cervical spine begins at the base of the skull and supports the weight of the head. The spinal cord runs from the brain down through the cervical spine, controlling the function of the body’s organs and limbs. In between each of the 7 vertebrae of the cervical spine are soft pads or discs which act as shock-absorbers and allow for bending and movement of the head. Each disc is made up of two parts, a soft center called the nucleus and a tough outer band called the annulus.
What is it?
Pain in the neck and extremities, among other symptoms, may occur when an intervertebral disc herniates – when the annulus fibrosus (tough, outer ring) of the disc tears and the nucleus pulposus (soft, jelly-like center) squeezes out and places pressure on neural structures, such as nerve roots or the spinal cord. Bony outgrowths, called bone spurs or osteophytes, which form when the joints of the spine calcify, may also cause these symptoms.
Anterior cervical discectomy with fusion is an operation that involves relieving the pressure placed on nerve roots and/or the spinal cord by a herniated disc or bone spurs – a condition referred to as nerve root compression.
Through A Small Incision Made Near The Front Of The Neck, The Surgeon : –
- Removes the intervertebral disc to access the compressed neural structures
- Relieves the pressure by removing the source of the compression
- Places a bone graft between the adjacent vertebrae, and
- In some cases, implants a small metal plate to stabilize the spine while it heals.
Discectomy involves removing all or part of an intervertebral disc. The term discectomy is derived from the Latin words discus (flat, circular object or plate) and -ectomy (removal). Spinal fusion involves placing bone graft between two or more opposing vertebrae to promote bone growth between the vertebral bodies.
The Operation in India
An understanding of what an anterior cervical discectomy with fusion involves will help you to approach your operation and recovery with confidence.
The operation is performed with you lying on your back. A small incision is made to one side of the front of your neck.
Material Placement in India
Through a separate incision, a small section of bone is obtained from your iliac crest (i.e., your hip) for use as a bone graft. The bone graft is placed in the disc space, where it helps the adjacent vertebrae to fuse.
Stabilization in India
A metal plate may be implanted on the front of the cervical spine to increase the stability of the spine immediately after the operation. Surgeons use these implants to decrease the amount of time that you have to wear a cervical collar after surgery and to increase your chances of developing a solid fusion.
The operation is completed when your surgeon closes and dresses the incision.
Your surgeon will have a specific post-operative recovery/exercise plan to help you return to normal life as soon as possible. The amount of time that you have to stay in the hospital will depend on this treatment plan. You will normally be up and walking in the hospital by the end of the first day after the surgery.