Anterior Cervical Discectomy and Fusion

Object The authors present their first experience, through retrospective study of a series of 10 patients, of treatment with ACDFP with Atlantis system of degenerative disease of cervical spine presented with radiculopathy without myelopathy.

Introduction Cervical disc disease and spondylosis are common in adult patients. Encompress several symptoms that results from damaged disc. Symptoms result from degenerated cervical disc, herniated disc, bulging disc, or disc-osteophyte complex. Depending on the neural element involved in this process, clinical presentation is with neck pain, radiculopathy, myelopathy or radiculomyelopathy. Anterior cervical discectomy and fusion (ACDF) is a surgical procedure performed to remove herniated or degenerative disc in cervical (neck) spine. After the disc is removed, the vertebrae above and below the disc space are fused together.

Material and Methods Out of 48 patients 28 were women and 20 were man. They all presented with signs and symptoms of cervical radiculopathy. Six patients presented with signs of cervical myelopathy in addition. Patients underwent CT scan and magnetic resonance imaging which demonstrated single-level disc herniation with evident radicular and/or spinal cord compression. All patients underwent single-level discectomy with interbody fusion and plating. PEEK cage was used in all cases, as well as plating system with locking screws. The mean follow-up period was 15 months.

Results All of the patients improved after surgery with reduction in neck and radicular pain and pain release after surgery. We evaluated neck disability index which improved in all of our patients. Fusion rate after 3, 6, and 12 months after surgery was good to excellent in 90% of the patients and shows good osseous fusion. Lordosis was measured as an overall feature compared with the patients of the same age, and measured at the level of fusion compared with the whole cervical spine. Less lordosis was observed in all cases compared with age-matched individuals. Also, less lordosis was observed at the level of fusion compared with overall cervical spine lordosis.

Conclusion Anterior plating system for anterior cervical discectomy with interbody fusion and plating has excellent fusion rates and clinical outcomes. We find that variable self-drilling screw construct supports all anatomical and biomechanical needs.