Cervical Spine Surgical Techniques and Outcomes
Summary
Cervical spine surgery encompasses a range of approaches designed to alleviate neural compression, restore spinal stability and preserve or re-establish physiological motion. Anterior cervical discectomy and fusion (ACDF) remains the predominant procedure for degenerative disc disease, utilising interbody cages or structural grafts with anterior plating or zero-profile constructs to encourage arthrodesis. Anterior cervical corpectomy and fusion (ACCF) extends this principle to multilevel pathology via vertebral body resection and titanium mesh cages. More recently, cervical disc arthroplasty (CDA) has gained traction as a motion-preserving alternative, aiming to reduce adjacent segment degeneration. Outcomes are assessed through fusion rates, neck disability indices and radiological parameters such as segmental alignment and range of motion. Complications include implant subsidence, heterotopic ossification and adjacent segment disease. Advances in cage design, biomechanics and implant materials seek to optimise load distribution, minimise stress shielding and improve long-term functional outcomes across diverse patient populations.
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Cervical Spine Surgical Techniques and Outcomes publication trend
The graph below shows the total number of articles in cervical spine surgical techniques and outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Anterior cervical discectomy and fusion (ACDF): Surgical removal of a cervical disc followed by insertion of a cage or graft and anterior plating to achieve segmental fusion.
Anterior cervical corpectomy and fusion (ACCF): Extended anterior decompression involving vertebral body resection and reconstruction with a mesh cage and plate to treat multilevel pathology.
Cervical disc arthroplasty (CDA): Motion-preserving replacement of a degenerative cervical disc with an artificial prosthesis to maintain segmental kinematics.
Subsidence: Postoperative sinking or settling of an interbody implant into the adjacent vertebral endplates, potentially altering alignment.
Zero-profile cage: Integrated interbody device that eliminates the need for an external anterior plate, reducing soft tissue irritation.
Finite element analysis: Computational technique for simulating mechanical behaviour of spinal constructs under physiological loading conditions.
References
- Biomechanical evaluation of a novel individualized zero-profile cage for anterior cervical discectomy and fusion: a finite element analysis. Frontiers in Bioengineering and Biotechnology (2023).
- Risk factors for subsidence of titanium mesh cage following single-level anterior cervical corpectomy and fusion. BMC Musculoskeletal Disorders (2020).
- Mid- to Long-Term Outcomes of Cervical Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion for Treatment of Symptomatic Cervical Disc Disease: A Systematic Review and Meta-Analysis of Eight Prospective Randomized Controlled Trials. PLOS ONE (2016).
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