Anterior Cervical Discectomy With Fusion and Plating for... : Operative Neurosurgery (original) (raw)

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Anterior Cervical Discectomy With Fusion and Plating for Correction of Degenerative Cervical Kyphosis: 2-Dimensional Operative Video

Guinn, Jeremy M V BS, BA; Pennicooke, Brenton MD, MS; Rivera, Joshua BA; Mummaneni, Praveen V MD; Chou, Dean MD

Correspondence: Jeremy M. V. Guinn, BS, BA Department of Neurological Surgery, 505 Parnassus Ave., Box 0112, University of California, San Francisco, San Francisco, CA 94143, USA. Email: [email protected]

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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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Funding

This study did not receive any funding or financial support.

Disclosures

The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. Dr Mummaneni is a consultant for Globus, DePuy Synthes, and Stryker, receives honoraria from Spineart, receives royalties from DePuy Synthes, Thieme Publishers, and Springer publishers, and stock in Spinicity/ISD, and receives grants from AO Spine and NREF. Dr Chou is a consultant for Medtronic and Globus, and receives royalties from Globus.

REFERENCE

1. Lau D, Ziewacz JE, Le H, Wadhwa R, Mummaneni PV. A controlled anterior sequential interbody dilation technique for correction of cervical kyphosis. J Neurosurg Spine. 2015;23(3):263-273.

Keywords:

Cervical; Kyphosis; Discectomy; Degeneration; ACDF; Anterior; Deformity