Subaxial cervical spine

Instrumentation techniques in the cervical spine were first described in 1891. Over 100 years have passed, and many surgeons have made contributions that now allow complicated operations to be performed with predictable results for many conditions affecting the cervical spine. The purpose of this chapter is to describe the currently acceptable techniques of instrumentation and fusion for the subaxial cervical spine. Because different devices are used, depending on whether the spine is approached from the front or from the back, this chapter is divided into those used through anterior and those used through posterior approaches. The decision to approach a given problem anteriorly or posteriorly depends on several factors including the location of the pathology, the nature of the underlying problem, the goals of the operation, and the experience of the surgeon.