Anterior Cervical Discectomy, Fusion, and Plating

Abstract

Anterior cervical discectomy, fusion, and plating is a routine technique in both neurosurgical and orthopedic surgery. Here, indications, technical prerequisites, approach, and performance as well as tips and tricks to avoid complications are illuminated. Anterior cervical decompression and fusion using an autologous bone graft has been developed by Bailey and Badgley (J Bone Joint Surg Am 42:565–594, 1960) and refined by Cloward (J Neurosurg 15:602–617, 1998), Smith and Robinson (J Bone Joint Surg Am 40:607–624, 1985), and Verbiest (J Bone Joint Surg Am 51:1489–1530, 1969). Using this technique for fixation of traumatic instability of the cervical spine, it was shown that the treated segment was prone to displacement (Van Petegham and Schweigel, J Trauma 19:110–114, 1979). To avoid graft complications such as graft dislocation or graft settling and to avoid the necessity of an external orthosis – i.e., a halo body jacket – anterior cervical plating was first used by Hermann (Acta Neurochir 32:101–111, 1975), who published his experiences in 1975.