Five-Level Anterior Cervical Discectomy And Fusion

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spine Surgery

Background:

• Anterior cervical discectomy and fusion (ACDF) is a standard treatment for cervical degenerative disc disease, offering high fusion rates (90-100%) and good clinical outcomes.
• Extreme multilevel ACDF (five or more levels) is rarely performed due to concerns about increased complication rates and the need for less cosmetically favorable longitudinal incisions.

Observation:

• This report details a case of a 63-year-old female with severe multilevel cervical degenerative disc disease (C3-T1) and kyphotic deformity causing upper extremity weakness.
• The patient underwent a five-level ACDF from C3 to T1, including partial corpectomies at C5 and C6.

Findings:

• The complex five-level ACDF was successfully accomplished using a standard transverse cervical incision, avoiding the need for a longitudinal incision.
• This approach highlights the feasibility of performing extensive multilevel ACDF through a cosmetically preferred incision with meticulous anatomical dissection.

Implications:

• This case suggests that extreme multilevel ACDF can be safely performed in select patients via a standard transverse incision, potentially improving cosmetic outcomes.
• Further research is warranted to compare complication and adjacent-segment disease rates between transverse and longitudinal incisions in extreme multilevel ACDF procedures.