Multilevel ACDF Versus Corpectomy
Anterior approaches to the cervical spine are routinely used to treat degenerative cervical spondylosis, as well as traumatic, neoplastic, and infectious pathologies. Improved clinical outcomes following the two most common procedures, anterior cervical discectomy and fusion (ACDF) and cervical corpectomy, are well established in the literature. Both techniques can be effectively used to alleviate pain and improve function by decompressing the neural elements and restoring stability and alignment to the cervical spine. However, there are inherent advantages and disadvantages associated with each technique that may favor ACDF or corpectomy in a given case. In this chapter, we will discuss anterior approaches to multilevel cervical pathology, including indications, surgical strategy, and technique. The advantages and disadvantages of cervical corpectomy will be compared and contrasted with multilevel ACDF. Special attention will be paid to a growing body of evidence that supports the use of a hybrid approach in select clinical scenarios, which incorporates both ACDF and corpectomy in a single construct.
KeywordsAnterior approaches Cervical spine Degenerative cervical spondylosis ACDF Cervical corpectomy
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