Department of Neurosurgery, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia; Department of Anatomy and Physiology, University of Applied Health Sciences, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee, United States.
Bosn J Basic Med Sci. 2021 Jun 1;21(3):258-260. doi: 10.17305/bjbms.2020.4895.
Anterior cervical discectomy and fusion (ACDF) is one of the most common spinal procedures, frequently used for the treatment of cervical spine degenerative diseases. It was first described in 1958. Interestingly, to our knowledge, 3-level ACDF has not been previously published as a peer-reviewed video case with a detailed description of intraoperative microsurgical anatomy. In this video, we present the case of a 33-year-old male who presented with a combination of myelopathy (hyperreflexia and long tract signs in the upper and lower extremities) and bilateral radiculopathy of the upper extremities. He had been previously treated conservatively with physical therapy and pain management for 6 months without success. We performed 3-level microsurgical ACDF from C4 to C7. All 3 levels were decompressed, and bone allografts were placed to achieve intervertebral body fusion. A titanium plate was utilized from C4 to C7 for internal fixation. The patient was discharged home on the first postoperative day. His pain, numbness and tingling resolved, as well as his myelopathy. No perioperative complications were encountered. Herein we present the surgical anatomy of our operative technique including certain technical tips. Written consent was obtained directly from the patient.
颈椎前路椎间盘切除融合术（ACDF）是最常见的脊柱手术之一，常用于治疗颈椎退行性疾病。它于 1958 年首次被描述。有趣的是，据我们所知，3 节段 ACDF 尚未以前瞻性同行评审视频病例的形式发表，也没有详细描述术中显微解剖结构。在本视频中，我们介绍了一位 33 岁男性患者的病例，他同时患有脊髓病（上下肢反射亢进和长束征）和双侧上肢神经根病。他曾接受过保守治疗，包括物理治疗和疼痛管理，但 6 个月后仍未成功。我们进行了 C4 到 C7 的 3 节段显微 ACDF。所有 3 个节段均进行减压，并用同种异体骨进行椎间融合。从 C4 到 C7 使用钛板进行内固定。患者术后第一天出院回家。他的疼痛、麻木和刺痛感得到缓解，脊髓病也得到改善。未发生围手术期并发症。本文介绍了我们手术技术的解剖结构，包括一些技术要点。直接从患者处获得了书面同意。
