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TITLE
STUDY OF FUNCTIONAL AND RADIOLOGICAL OUTCOME OF ANTERIOR CERVICAL DISCECTOMY

AND FUSION
NAME OF THE PRINCIPAL WORKER
DR.SHAILESH S. SHEVALE (RESIDENT MS ORTHOPAEDICS)
NAME OF GUIDE
DR.JAYANT D. THIPSE (PROF AND HOD ORTHOPAEDICS DEPARTMENT)
ADDRESS:
Dept. of orthopaedics
PDVVPF’S MEDICAL COLLEGE & HOSPITAL,VILAD GHAT,
AHMEDNAGAR-414111,MAHARASHTRA
MOBILE NO.-9665908183
SYNOPSIS:
Introduction
Anterior cervical discectomy and fusion procedures are one of the most common procedures
performed in spinal surgery.4 Since its original description over 50 years ago, numerous studies
have demonstrated the effectiveness of ACDF; patients generally experience rapid recoveries,
and dramatic improvement in their quality of life.8,9
Indications for anterior cervical discectomy & fusion
1.Cervical myelopathy encompasses a range of symptoms and examination findings including

motor and sensory abnormalities related to dysfunction of the cervical spinal cord. The
pathophysiology of CSM is now thought to be multifactorial with both static factors causing
stenosis and dynamic factors resulting in repetitive injury to the spinal cord playing a role.
2.cervical trauma (fractures, subluxations, ligamentous instability, or a combination of these

problems) were treated with plating.
Anterior cervical discectomy and fusion (ACDF) is the current gold standard for managing
symptomatic anterior cervical degenerative disc disease.It gives rapid symptomatic relief as
compared to physiotherapy or cervical collar immobilization. Anterior cervical discectomy and
ACD with fusion (ACDF) are associated with longer term (12 months) improvement in certain
motor functions compared to PT.
There are 3 commonly used techniques for anterior cervical spine fusion. Those of Robinson –
Smith, Bailey and Badgley and Cloward. The Robinson-Smith used tricortical iliac crest
autograft, Bailey and Badgley used slot or trough type graft and Cloward used circular dowel
graft. The Robinson-smith is found to be strongest in compressive loading.1
This study is intended to assess the functional and radiological outcome of anterior cervical
discectomy and fusion, its technical difficulties and outcome.
MATERIAL & METHODS
MATERIAL:-General orthopedic spine instruments,Bipolar cautery,Anterior cervical plates and

screw set,Skin hooks,Kochers clamp,Burr,Oscillating saw
SMITH ROBINSONS APPROACH:-Place the patient supine on the operating table under
general anesthesia with the patients head slightly rotated to the side opposite the planned
approach.
Incision is taken along the anterior cervical skin crease along the medial border of the
sternocleidomastoid. After dividing the skin, sharp dissection of the subcutaneous layer and the
platysma is carried out by lifting it in between two pairs of skin hooks.
Interval is developed medial to SCM and between carotid sheath and omohyoid andpretracheal
fascia is divided medial to the carotid sheath and the longus colli muscles are visualized after
blunt finger dissection.
A localization radiograph is obtained using a prebent needle to mark the spinal level. A 11 no
blade is used to remove anterior annulus at the desired level cutting toward midline from the
uncovertebral joint. Disc forceps are used to remove the disc from that space.
The adjacent endplates are prepared using a burr so that all cartilage is removed, subchondral
bone is preserved and endplates are parallel to each other.
Measurement of the anteroposterior dimension and the cephalocaudal dimension is done between
the endplates under traction.
A tricortical iliac graft is obtained of the appropriate size using a oscillating saw and the bone
graft is fashioned to appropriate depth.
The graft is held with Kochers clamps and positioned with the cancellous surface directed
posteriorly with traction applied.
Anterior cervical instrumentation is applied and fixed with appropriate sized screws with traction
released. Intraoperative radiographs are obtained to verify graft and hardware position and
wound is closed and dressing is done and cervical collar is placed before extubation.
LIKELY BENEFIT OF THE STUDY TO THE SOCIETY
Early symptomatic relief & recovery of the patient
ANY ETHICAL ISSUES LIKELY TO BE INVOLVED:NO
EXPECTED OUTCOME
Useful & beneficial to the patients participating in the study
WHETHER ANY NEW WORK/REPEATING OLD STUDY/REPEATING OLD STUDY FOR
NEW GEOGRAPHIC AREA:NO
NAME OF THE STATISTICIAN/A TEACHER IN COMMUNITY MEDICINE WITH
KNOWLEDGE IN STATISTICS CONSULTED FOR DESIGNING THE
STUDY,POPULATION SIZE,STATISTICAL METHODS TO BE USED FOR ANALYSIS OF
THE DATA ON COMPLETION
COMMENT & SIGNATURE OF THE STSTISTICIAN WITH NAME & SEAL
SIGNATURE OF THE PRINCIPAL WORKER/STUDENT
SIGNATURE OF CO-WORKER/GUIDE
SIGNATURE OF THE HEAD OF THE DEPARTMENT
SIGNATURE OF THE PRINCIPAL

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TITLE

STUDY OF FUNCTIONAL AND RADIOLOGICAL OUTCOME OF ANTERIOR CERVICAL DISCECTOMY

NAME OF THE PRINCIPAL WORKER

DR.SHAILESH S. SHEVALE (RESIDENT MS ORTHOPAEDICS)

DR.JAYANT D. THIPSE (PROF AND HOD ORTHOPAEDICS DEPARTMENT)

PDVVPF’S MEDICAL COLLEGE & HOSPITAL,VILAD GHAT,

Indications for anterior cervical discectomy & fusion

1.Cervical myelopathy encompasses a range of symptoms and examination findings including

2.cervical trauma (fractures, subluxations, ligamentous instability, or a combination of these

MATERIAL & METHODS

MATERIAL:-General orthopedic spine instruments,Bipolar cautery,Anterior cervical plates and

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