Anterior cervical corpectomy and fusion for cervical spine disorders: Institutional insights

Cervical radiculomyelopathy may result from degenerative, traumatic, or infectious causes, leading to spinal cord compression. Anterior cervical corpectomy and fusion (ACCF) is a well-established surgical technique for decompressing the spinal cord and stabilizing the cervical spine. This study aims to evaluate the clinical and radiological outcomes of ACCF in patients with cervical spondylotic myelopathy (CSM), traumatic cervical spine injuries, and infectious conditions.

A retrospective study was conducted on 86 patients who underwent ACCF at a tertiary care center, between May 2019 and April 2023. Patients were grouped into three categories based on etiology: CSM, trauma, and infection. Surgical reconstruction was performed using either autologous iliac crest grafts with anterior plate and screw fixation or titanium mesh cage (TMC) with/without additional instrumentation. All patients were followed clinically and radiologically at 3 months and 1 year postoperatively.

Neck pain was the most common symptom across all groups. Significant improvement in neck pain and neurological deficits was observed at follow-up, especially in the CSM and trauma groups. Radiologically, proper graft alignment was achieved in the majority, with minimal graft migration noted in a few cases. Two patients required revision surgery due to instability. Complications included dysphagia, cerebrospinal fluid leak, recurrent laryngeal nerve palsy, and donor site infection. Fusion was achieved in all cases by the 1-year follow-up.

ACCF is a safe and effective procedure for managing cervical spine pathologies, offering good neurological recovery and high fusion rates. TMCs reduce donor site morbidity and are a viable alternative to autografts.