Anterior cervical diskectomy and fusion (ACDF)
Disk herniations of the cervical spine can be treated by either ACDF or posterior foraminotomy/diskectomy. ACDF involves making an incision in the front of the neck, dissecting down to the spine, removing the entire disk and disk herniation, then fusing the disk space using allograft (either donated bone from a cadaver, PEEK, or titanium) or autograft (bone taken from patient’s own body).
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Posterior cervical foraminotomy (PCF)
Foraminal stenosis in the cervical spine can be treated with an incision in the back of the neck then removing the bone spur compressing the nerve. A diskectomy (removing the herniated portion of the disk) can also be performed. Typically a fusion is not performed. However, a fusion also can be done in selected circumstances.
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Artificial disk replacement (ADR)
ADR has been approved for the lumbar spine and cervical spine. ADR is an alternative to fusion of the lumbar or cervical spine. However, only certain types of patients are candidates for this surgery.
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Laminectomy
Laminectomy (removing the lamina of the spine) is done to decompress the central spinal canal. The procedure is most commonly performed to treat myelopathy due to spinal cord compression. Laminectomy can be accompanied by a fusion in selected cases.
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Laminoplasty
Laminoplasty is also used to treat cervical stenosis with myelopathy. However, instead of discarding the lamina like done in Laminectomy, the lamina are re-attached to the spine using metal plates and mini-screws.
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Posterior cervical fusion
This procedure involves fusion of the facets of the cervical spine. Fusion is often done with instrumentation. Some type of decompression (laminectomy, foraminotomy) is typically performed with the fusion.
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Chiari decompression
The objective is to decompress the foramen magnum (the hole in bottom of the skull through which the spinal cord joins the brain). By doing so, the tonsils of the cerebellum (the back of the brain) are decompressed and no longer push on the spinal cord. Often a duraplasty (expanding the dura mater (the covering over the brain) is also performed.
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