Endo-ACDF with a rigid bendable burr for lesions located at posterior vertebral body: a technical note

Anterior cervical discectomy and fusion (ACDF), featuring a high fusion rate and favourable clinical outcomes, has always been the gold standard technique for treating cervical spondylosis.¹ With significant advancements in optical technology, surgical instruments, and imaging systems, a variety of new devices have been successively applied in ACDF to enhance its advantages. However, lesions located at posterior vertebral body remains a challenge for ACDF. To solve this problem, we have explored a technique that utilizes endoscope-assisted ACDF (Endo-ACDF) with a rigid bendable burr. During the surgery, a rigid bendable burr is used to perform bone resection on the upper and lower endplates of the target intervertebral space to expose the lesion, and then other instruments are used to complete the removal. The rigid bendable burr and the clear endoscopic field of view can help the surgeon achieve complete removal of lesions through a single-segment discectomy, while maintaining the advantages of traditional ACDF. Compared with the use of nonbendable burr, we speculate that this technique can achieve the removal of posterior vertebral lesions while preserving more vertebral bone mass. Therefore, in this article, we elaborated in detail on the technique of utilizing Endo-ACDF with a rigid bendable burr.