Background: Risks of inadequate decompression or neural injury during conventional Anterior Cervical Discectomy with Fusion (ACDF) surgery is not uncommon specially in cases with large posterior osteophytes or migrating fragments. Usage of High-speed Drill instead of Curettes and Kerrison Rongeurs may has a role for safe and adequate decompression.
Aim: To assess the efficacy and safety of using high speed drill during ACDF surgery in comparison to conventional approach. Design: A retrospective comparative study. Methods: 60 Patients were divided into 2 groups; Group A, 30 patients who underwent Conventional ACDF surgery without using high speed drill, and group B, 30 patients underwent ACDF with the aid of high-speed drill. Results: Postoperative VAS of neck pain and Upper limbs in both groups had nearly the same end results with no statistically significant difference. In Group A: the mean Postoperative Odom's criteria was 1.47 ± 0.629 SD, while Group B showed nearly the same values. As regards the Japanese Orthopedic Association score (JOA score), Group B showed better results with mean JOA score value equals 15.7 ± 1.02 SD, which showed statistically significant difference between both groups with p-value 0.015. In addition, Group B showed slightly better results as regards operation time and intraoperative Blood loss but with no statistically significant difference. Conclusion: High speed drill is an efficient and safe tool that can be used in ACDF surgery for adequate neural decompression, with good clinical and radiological outcomes comparable to conventional methods, even with better neurological outcome and less operative time.