Anterior cervical discectomy and fusion

Really, really important because cervical fusion is not a rare procedure.

Over 180,000 cervical fusions are performed every year just in the United States with ACDF anterior cervical disectomy infusion.

that's through the front of course making up a majority of those procedures and generally speaking you know outcomes can be okay you know the paper's not saying fusion doesn't work it's really analyzing what happens afterwards specifically that adjacent segment disease so they they cite that adjacent segment disease occurs approximately three percent per year um And that's important because that's compounding over time.

When I first read the 3%, I'm like, that is a joke.

The overarching choice for the spine surgeon usually distills down to anterior versus posterior approaches.

From the front, we have the anterior cervical disectomy and fusion, the ACDF, and the more extensive corpectomy.

the workhorses of anterior surgery.

And from the back, we have the laminoplasty and the laminectomy with fusion.

It's 3D chess.

Let's start with the front.

Let's start with the anterior approaches, the ACDF and the anterior crepectomy.

In these procedures, you approach the spine from the front of the neck.

Let's run through the menu.

Anteriorly, from the front of the neck, we have the ACDF anterior cervical disectomy infusion.

and the anterior cervical crepectomy.

And from the back.

Let us spend some significant time detailing the anatomical rationale for each, because this is where the biomechanics really dictate the success of the decompression.

Let us start with the anterior approach.

When is an ACDF or a crepectomy The mandated choice.

The anterior approach is logically chosen when the primary pathology is ventral.