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Anterior Cervical Decompression and Fusion ACDF Live Spine Surgery Tutorial Spine Surgeon
Hello this is corenman we’re going to go through a tutorial and animation of an anterior cervical decompression and fusion C six seven here you see a side view xray lateral xray where there’s an angulation and here you see the MRI with the herniation at the base of the spine this is a normal level transversely.
And the next picture will be the hernaited disc where you see it’s compressing both the cord as well as the two holes the nerves exit we first start with a small transverse incision on the side of the neck point and we disect directly onto the anterior part of the neck we put in these two small distraction pins called caspar pins.
That allows us to pull the vertebra apart to its normal height typically these vertebra have collapsed at least half way this is a picture of what the annulus itself looks like in a live tutorial you can see this little penfield going into the tear that tear obviously should be attached to that vertebra but this patient has torn off their annulus.
We then take off the anterior aspect of the annulus and this tutorial depicts how it’s done in a simple matter and we’ll see how we do it using a typical eleven blade here is the little tiny scalpel.
That goes in and removes this annulus the nucleus is missing in this patient it had actually dissolved away and the rest of it went to the back of the neck compressing the nerves here we see a small tool removing this.
Portion of the annulus we then remove the spurs on the front portion of the neck so we can get the two vertebra parallel and have a good spot to dock our plate in addition it allows us to be able to know the depth.
Of the graft that we need here we see a burr taking off theses spurs once we have the spurs in the front removed we then need to remove the spurs that occur within the disc itself and we see this little dremel type device the burr removing that bone and here we see a live version of the same thing where the burr actually takes the spur off the bone.
And we need to have the end plates parallel because the end plates in a typical cervical vertebra have some curve to them and in order to be accepting of a good placement of a graft we have to take these end plates down we then curette the cartilage that sits on each end plate.