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Anterior Cervical Decompression and Arthrodesis/Arthroplasty

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Surgery of the Spine and Spinal Cord

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Abstract

Cervical spine degenerative pathologies remain one of the most common spinal conditions treated by spine surgeons worldwide. While a significant proportion of patients with degenerative changes are asymptomatic, these can often become symptomatic resulting in various symptom complexes. The initial process begins with disc degeneration that can progress to disc herniation, facet joint osteoarthrosis, and osteophytic spur formation. These changes can produce axial neck pain, radiculopathy, cervical myelopathy, deformity, or any combination of these. The pathophysiology of clinical symptoms is likely multifactorial and often involves static compression, congenitally stenotic canal, and dynamic factors which can result in inflammation, cellular apoptosis, and microvascular alterations. Considering the variable but often benign and slowly progressive natural history, nonoperative management is initially the preferred choice of treatment for patients with cervical radiculopathy and mild cervical spondylotic myelopathy (CSM) except in cases with moderate to severe myelopathy.

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References

  1. Karadimas SK, Erwin WM, Ely CG, Dettori JR, Fehlings MG (2013) Pathophysiology and natural history of cervical spondylotic myelopathy. Spine (Phila Pa 1976) 38:S21–S36

    Article  Google Scholar 

  2. Wilson JR, Barry S, Fischer DJ, Skelly AC, Arnold PM, Riew KD, Shaffrey CI, Traynelis VC, Fehlings MG (2013) Frequency, timing, and predictors of neurological dysfunction in the nonmyelopathic patient with cervical spinal cord compression, canal stenosis, and/or ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976) 38:S37–S54

    Article  Google Scholar 

  3. Bono CM, Ghiselli G, Gilbert TJ, Kreiner DS, Reitman C, Summers JT, Baisden JL, Easa J, Fernand R, Lamer T, Matz PG, Mazanec DJ, Resnick DK, Shaffer WO, Sharma AK, Timmons RB, Toton JF, North American Spine S (2011) An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders. Spine J 11:64–72

    Article  PubMed  Google Scholar 

  4. Robinson RS (1955) Anterolateral cervical disk removal and interbody fusion for cervical disk syndrome. Bull Johns Hopkins Hosp 96:223–224

    Google Scholar 

  5. Southwick WO, Robinson RA (1957) Surgical approaches to the vertebral bodies in the cervical and lumbar regions. J Bone Joint Surg Am 39-A:631–644

    CAS  PubMed  Google Scholar 

  6. Hilibrand AS, Robbins M (2004) Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J 4:190S–194S

    Article  PubMed  Google Scholar 

  7. Botelho RV, Moraes OJ, Fernandes GA, Buscariolli Ydos S, Bernardo WM (2010) A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus 28:E5

    Article  PubMed  Google Scholar 

  8. Burkus JK, Traynelis VC, Haid RW Jr, Mummaneni PV (2014) Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the prestige prospective randomized controlled clinical trial: clinical article. J Neurosurg Spine 21:516–528

    Article  PubMed  Google Scholar 

  9. Davis RJ, Kim KD, Hisey MS, Hoffman GA, Bae HW, Gaede SE, Rashbaum RF, Nunley PD, Peterson DL, Stokes JK (2013) Cervical total disc replacement with the Mobi-C cervical artificial disc compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled multicenter clinical trial: clinical article. J Neurosurg Spine 19:532–545

    Article  PubMed  Google Scholar 

  10. Fiere V, Greff G, Mosnier T, Faline A (2013) New cervical compressive staple: in vitro testing and early clinical results. J Spinal Disord Tech 26:385–392

    Article  PubMed  Google Scholar 

  11. Kasliwal MK, Traynelis VC (2012) Motion preservation in cervical spine: review. J Neurosurg Sci 56:13–25

    CAS  PubMed  Google Scholar 

  12. Pickett GE, Sekhon LH, Sears WR, Duggal N (2006) Complications with cervical arthroplasty. J Neurosurg Spine 4:98–105

    Article  PubMed  Google Scholar 

  13. Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, Lee GP, Robinson JS Jr (2007) Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976) 32:2310–2317

    Article  Google Scholar 

  14. Weisberg NK, Spengler DM, Netterville JL (1997) Stretch-induced nerve injury as a cause of paralysis secondary to the anterior cervical approach. Otolaryngol Head Neck Surg 116:317–326

    Article  CAS  PubMed  Google Scholar 

  15. Apfelbaum RI, Kriskovich MD, Haller JR (2000) On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine (Phila Pa 1976) 25:2906–2912

    Article  CAS  Google Scholar 

  16. Clarke E, Robinson PK (1956) Cervical myelopathy: a complication of cervical spondylosis. Brain: J Neurol 79:483–510

    Article  CAS  Google Scholar 

  17. Lees F, Turner JW (1963) Natural history and prognosis of cervical spondylosis. Br Med J 2:1607–1610

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Kadanka Z, Bednarik J, Novotny O, Urbanek I, Dusek L (2011) Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years. Eur Spine J 20:1533–1538

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kadanka Z, Mares M, Bednanik J, Smrcka V, Krbec M, Stejskal L, Chaloupka R, Surelova D, Novotny O, Urbanek I, Dusek L (2002) Approaches to spondylotic cervical myelopathy: conservative versus surgical results in a 3-year follow-up study. Spine (Phila Pa 1976) 27:2205–2210; discussion 2210–2211

    Article  Google Scholar 

  20. Symon L, Lavender P (1967) The surgical treatment of cervical spondylotic myelopathy. Neurology 17:117–127

    Article  CAS  PubMed  Google Scholar 

  21. Sampath P, Bendebba M, Davis JD, Ducker TB (2000) Outcome of patients treated for cervical myelopathy. A prospective, multicenter study with independent clinical review. Spine (Phila Pa 1976) 25:670–676

    Article  CAS  Google Scholar 

  22. Albert GW, Menezes AH (2011) Ankylosing spondylitis of the craniovertebral junction: a single surgeon’s experience. J Neurosurg Spine 14:429–436

    Article  PubMed  Google Scholar 

  23. Akula M, Taha M, Mathew B, O’Reilly G (2008) The Plate cage Benezech implant as an alternative to autologous bone graft in the treatment of cervical spondylosis: clinical and functional outcome. Br J Neurosurg 22:542–545

    Article  CAS  PubMed  Google Scholar 

  24. Matz PG, Anderson PA, Holly LT, Groff MW, Heary RF, Kaiser MG, Mummaneni PV, Ryken TC, Choudhri TF, Vresilovic EJ, Resnick DK, Joint Section on Disorders of the S, Peripheral Nerves of the American Association of Neurological S, Congress of Neurological S (2009) The natural history of cervical spondylotic myelopathy. J Neurosurg Spine 11:104–111

    Article  PubMed  Google Scholar 

  25. Xie JC, Hurlbert RJ (2007) Discectomy versus discectomy with fusion versus discectomy with fusion and instrumentation: a prospective randomized study. Neurosurgery 61:107–116; discussion 116–117

    Article  PubMed  Google Scholar 

  26. Lewis DJ, Attiah MA, Malhotra NR, Burnett MG, Stein SC (2014) Anterior surgical management of single-level cervical disc disease: a cost-effectiveness analysis. Spine (Phila Pa 1976) 39:2084–2092

    Article  Google Scholar 

  27. Ahn Y, Moon KS, Kang BU, Hur SM, Kim JD (2012) Laser-assisted posterior cervical foraminotomy and discectomy for lateral and foraminal cervical disc herniation. Photomed Laser Surg 30:510–515

    Article  PubMed  Google Scholar 

  28. Jagannathan J, Shaffrey CI, Oskouian RJ, Dumont AS, Herrold C, Sansur CA, Jane JA (2008) Radiographic and clinical outcomes following single-level anterior cervical discectomy and allograft fusion without plate placement or cervical collar. J Neurosurg Spine 8:420–428

    Article  PubMed  Google Scholar 

  29. Samartzis D, Shen FH, Lyon C, Phillips M, Goldberg EJ, An HS (2004) Does rigid instrumentation increase the fusion rate in one-level anterior cervical discectomy and fusion? Spine J 4:636–643

    Article  PubMed  Google Scholar 

  30. Banwart JC, Asher MA, Hassanein RS (1995) Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine (Phila Pa 1976) 20:1055–1060

    Article  CAS  Google Scholar 

  31. Chau AM, Mobbs RJ (2009) Bone graft substitutes in anterior cervical discectomy and fusion. Eur Spine J 18:449–464

    Article  PubMed  PubMed Central  Google Scholar 

  32. Rosenorn J, Hansen EB, Rosenorn MA (1983) Anterior cervical discectomy with and without fusion. A prospective study. J Neurosurg 59:252–255

    Article  CAS  PubMed  Google Scholar 

  33. van den Bent MJ, Oosting J, Wouda EJ, van Acker RE, Ansink BJ, Braakman R (1996) Anterior cervical discectomy with or without fusion with acrylate. A randomized trial. Spine (Phila Pa 1976) 21:834–839; discussion 840

    Article  Google Scholar 

  34. Savolainen S, Rinne J, Hernesniemi J (1998) A prospective randomized study of anterior single-level cervical disc operations with long-term follow-up: surgical fusion is unnecessary. Neurosurgery 43:51–55

    Article  CAS  PubMed  Google Scholar 

  35. Dowd GC, Wirth FP (1999) Anterior cervical discectomy: is fusion necessary? J Neurosurg 90:8–12

    CAS  PubMed  Google Scholar 

  36. Murphy MG, Gado M (1972) Anterior cervical discectomy without interbody bone graft. J Neurosurg 37:71–74

    Article  CAS  PubMed  Google Scholar 

  37. Barlocher CB, Barth A, Krauss JK, Binggeli R, Seiler RW (2002) Comparative evaluation of microdiscectomy only, autograft fusion, polymethylmethacrylate interposition, and threaded titanium cage fusion for treatment of single-level cervical disc disease: a prospective randomized study in 125 patients. Neurosurg Focus 12:E4

    Article  PubMed  Google Scholar 

  38. Li GL, Hu JZ, Lu HB, Qu J, Guo LY, Zai FL (2015) Anterior cervical discectomy with arthroplasty versus anterior cervical discectomy and fusion for cervical spondylosis. J Clin Neurosci: Off J Neurosurg Soc Australas 22:460–467

    Article  Google Scholar 

  39. Yue WM, Brodner W, Highland TR (2005) Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study. Spine (Phila Pa 1976) 30:2138–2144

    Article  Google Scholar 

  40. Ames CP, Blondel B, Scheer JK, Schwab FJ, Le Huec JC, Massicotte EM, Patel AA, Traynelis VC, Kim HJ, Shaffrey CI, Smith JS, Lafage V (2013) Cervical radiographical alignment: comprehensive assessment techniques and potential importance in cervical myelopathy. Spine (Phila Pa 1976) 38:S149–S160

    Article  Google Scholar 

  41. Woods BI, Hilibrand AS (2015) Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech 28:E251–E259

    Article  PubMed  Google Scholar 

  42. Mansfield HE, Canar WJ, Gerard CS, O’Toole JE (2014) Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis. Neurosurg Focus 37:E9

    Article  PubMed  Google Scholar 

  43. Alvin MD, Lubelski D, Abdullah KG, Whitmore RG, Benzel EC, Mroz TE (2014) Cost-utility analysis of anterior cervical discectomy and fusion with plating (ACDFP) versus posterior cervical foraminotomy (PCF) for patients with single-level cervical radiculopathy at 1-year follow-up. J Spinal Disord Techn

    Google Scholar 

  44. Tumialan LM, Ponton RP, Gluf WM (2010) Management of unilateral cervical radiculopathy in the military: the cost effectiveness of posterior cervical foraminotomy compared with anterior cervical discectomy and fusion. Neurosurg Focus 28:E17

    Article  PubMed  Google Scholar 

  45. Shamji MF, Cook C, Pietrobon R, Tackett S, Brown C, Isaacs RE (2009) Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis. Spine J 9:31–38

    Article  PubMed  Google Scholar 

  46. Fehlings MG, Barry S, Kopjar B, Yoon ST, Arnold P, Massicotte EM, Vaccaro A, Brodke DS, Shaffrey C, Smith JS, Woodard E, Banco RJ, Chapman J, Janssen M, Bono C, Sasso R, Dekutoski M, Gokaslan ZL (2013) Anterior versus posterior surgical approaches to treat cervical spondylotic myelopathy: outcomes of the prospective multicenter AOSpine North America CSM study in 264 patients. Spine (Phila Pa 1976) 38:2247–2252

    Article  Google Scholar 

  47. Emery SE, Fisher JR, Bohlman HH (1997) Three-level anterior cervical discectomy and fusion: radiographic and clinical results. Spine (Phila Pa 1976) 22:2622–2624; discussion 2625

    Article  CAS  Google Scholar 

  48. Wang JC, McDonough PW, Kanim LE, Endow KK, Delamarter RB (2001) Increased fusion rates with cervical plating for three-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 26:643–646; discussion 646–647

    Article  CAS  Google Scholar 

  49. Wright IP, Eisenstein SM (2007) Anterior cervical discectomy and fusion without instrumentation. Spine (Phila Pa 1976) 32:772–774; discussion 775

    Article  Google Scholar 

  50. Chang SW, Kakarla UK, Maughan PH, DeSanto J, Fox D, Theodore N, Dickman CA, Papadopoulos S, Sonntag VK (2010) Four-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Neurosurgery 66:639–646; discussion 646–647

    Article  PubMed  Google Scholar 

  51. Papadopoulos EC, Huang RC, Girardi FP, Synnott K, Cammisa FP Jr (2006) Three-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Spine (Phila Pa 1976) 31:897–902

    Article  Google Scholar 

  52. Song KJ, Yoon SJ, Lee KB (2012) Three- and four-level anterior cervical discectomy and fusion with a PEEK cage and plate construct. Eur Spine J 21:2492–2497

    Article  PubMed  PubMed Central  Google Scholar 

  53. Connolly PJ, Esses SI, Kostuik JP (1996) Anterior cervical fusion: outcome analysis of patients fused with and without anterior cervical plates. J Spinal Disord 9:202–206

    CAS  PubMed  Google Scholar 

  54. Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, Vaccaro AR, Albert TJ (2003) Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 28:134–139

    Article  Google Scholar 

  55. Shamji MF, Massicotte EM, Traynelis VC, Norvell DC, Hermsmeyer JT, Fehlings MG (2013) Comparison of anterior surgical options for the treatment of multilevel cervical spondylotic myelopathy: a systematic review. Spine (Phila Pa 1976) 38:S195–S209

    Article  Google Scholar 

  56. Burkhardt J, Mannion FA (2014) Two-level anterior discectomy with fusion : does anterior cervical plate fixation influences radiographic and patient-related outcomes? Eurospine, Lyon

    Google Scholar 

  57. Hisey M, Davis R, Nunley P, Kim K, Bae H, Jackson R (2014) One-level treatment with rotal disc replacement and ACDF: five-year results from a prospective randomized clinical trial. In: 25S SJp (ed) Annual meeting of the North American Spine Society, San Francisco

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA

    Manish K. Kasliwal MD, MCh & Vincent C. Traynelis MD

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  1. Manish K. Kasliwal MD, MCh
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  2. Vincent C. Traynelis MD
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Correspondence to Vincent C. Traynelis MD .

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Editors and Affiliations

  1. Dept. of Neurosurgery, AZ Nikolaas, Sint-Niklaas, Belgium

    Erik van de Kelft

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Kasliwal, M.K., Traynelis, V.C. (2016). Anterior Cervical Decompression and Arthrodesis/Arthroplasty. In: van de Kelft, E. (eds) Surgery of the Spine and Spinal Cord. Springer, Cham. https://doi.org/10.1007/978-3-319-27613-7_12

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  • DOI: https://doi.org/10.1007/978-3-319-27613-7_12

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