ANTERIOR CERVICAL ARTHRODESIS WITH INTERVERTEBRAL SPACER AND CYLINDRIC BONE SUPPORT

Abstract

ABSTRACT The anterior cervical discectomy and fusion is considered an established technique in cervical degenerative disease treatment, in which the final goal is the fusion of the segments involved. There are options for spacer grafts, such as bone grafts and synthetic bone substitutes like hydroxyapatite and tricalcium phosphate. This technical note describes the combination of the stand-alone anchored intervertebral spacer and iliac graft, which is used as a pillar between the vertebrae. The iliac crest removal is performed with a 10 mm or 12 mm diameter trephine. The trephine is employed to make a graft in the same format as the inner portion of the intervertebral spacer. The cylindrical bone graft removed must be 1 millimeter higher than the cage that will be implanted so that it is 0.5 mm above and below the upper and lower edges of the cage. The objective is to establish support between the vertebral plateaus and the bone cylinder, as they present similar resistance and biological aspects, which are fundamental characteristics for proper osseointegration and fusion. When the conventional technique is used, the interaction between the cage and the plateaus occurs more intensely, and a plateau fracture may occur, a phenomenon known as subsidence. This technical note describes a feasible way to obtain autograft bone to be used in ACDF stand-alone surgery. This type of graft may be associated with lower rates of pseudoarthrosis. Level of Evidence IV; Case Series.

Keywords

• Diskectomy
• Iliac Crest
• Transplantation
• Autologous
• Surgical Procedures
• Operative