Anterior Cervical Discectomy and Fusion using the DePuy Zero-P VA cage
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Anterior cervical discectomy and fusion (ACDF) is a fairly common spinal operation and involves an anterior approach to the cervical spine. The disc space is cleared to decompress the spinal cord or cervical nerve roots. Classically the operation would be finished at this point and left to its own devices and often the spinal segment would go on to fuse, but not invariably. The operated cervical spine segment could also kyphose over time in some patients this leads to progressive deformity and pain or foraminal narrowing. The alternative is to insert a spacer into the disc space to promote union across the disc space. Spacers can be autograft, disc replacements, a stand alone cage, a cage supplemented by plating, or a cage with integrated screws. The cage with integrated screws offers many benefits such as ease of insertion, less bulk that a plate, and good reported outcomes.
The DePuy Zero-P VA described in this technique is a fusion cage that offers ease of insertion and a simple operative technique. The instrumentation that supports its implantation is well thought out and assists the task. There are both straight and angled awls, drills, and screwdrivers as standard and the insertion holder is stable and not too bulky. The implants themselves also have small phalanges which stop them being placed too deep into the disc space during insertion.
Author: Mr Andrew Young, FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital, Birmingham, UK.
Clinicians should seek clarification on whether any implant demonstrated is licensed for use in their own country.