Guinn Jeremy M V, Pennicooke Brenton, Rivera Joshua, Mummaneni Praveen V, Chou Dean
Oper Neurosurg (Hagerstown). 2021 Feb 16;20(3):E214. doi: 10.1093/ons/opaa339.
This surgical video demonstrates the technique for correcting degenerative cervical kyphosis using an anterior cervical discectomy and fusion (ACDF). Degenerative cervical kyphosis can cause radiculopathy, myelopathy, and difficulty holding up one's head. The goal of surgical intervention is to alleviate pain, improve the ability for upright gaze, and decompress the spinal cord or nerve roots. Posterior-only approaches and anterior corpectomies are alternative treatments to address cervical kyphosis. However, an ACDF allows for sequential induction of lordosis via distraction over multiple segments and for further lordosis induction by sequential screw tightening, pulling the spine towards a lordotic cervical plate.1 This video shows 2 cases demonstrating a technique of correcting severe cervical degenerative kyphosis. The video illustrates our initial kyphotic Caspar pin placement coupled with sequential anterior distraction to correct kyphosis. The technique is most useful in patients who have good bone density, nonankylosed facets, and degenerative cervical kyphosis. We have received informed consent of this patient to submit this video.
本手术视频展示了使用颈椎前路椎间盘切除融合术(ACDF)矫正退行性颈椎后凸畸形的技术。退行性颈椎后凸畸形可导致神经根病、脊髓病以及抬头困难。手术干预的目标是减轻疼痛、提高直立凝视能力并对脊髓或神经根进行减压。单纯后路手术和前路椎体次全切除术是治疗颈椎后凸畸形的替代方法。然而,ACDF可通过多个节段的撑开逐步诱导前凸,并通过依次拧紧螺钉进一步诱导前凸,将脊柱拉向颈椎前凸钢板。1本视频展示了2例矫正严重颈椎退行性后凸畸形技术的病例。该视频展示了我们最初放置凯斯帕氏针以矫正后凸畸形并结合逐步前路撑开的过程。该技术对骨密度良好、关节突未融合且患有退行性颈椎后凸畸形的患者最为有用。我们已获得该患者提交此视频的知情同意。