Circumferential Operations of the Cervical Spine

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spine Surgery

Background:

• Combined anterior and posterior cervical approaches often lead to increased morbidity, longer operative times, and greater blood loss.
• Despite potential complications, circumferential cervical fusion can be advantageous in select cases.

Purpose of the Study:

• To discuss the indications for circumferential cervical spine procedures.
• To review the specific patient populations and conditions where this surgical approach is beneficial.

Main Methods:

• A narrative review of existing literature was performed.
• Indications were compiled based on a review of the senior author's experience and published data.

Main Results:

• Key indications include high-risk pseudoarthrosis patients, cervical deformity, spinal metastases, infection, unstable trauma, movement disorders, multiply operated patients, and when early fusion is desired.
• Circumferential approaches can be beneficial across diverse cervical spine pathologies.

Conclusions:

• Circumferential cervical procedures are valuable for various conditions, particularly in reducing pseudoarthrosis risk.
• The benefits must be carefully weighed against the inherent risks of a combined anterior-posterior approach.
• Meticulous preoperative planning and surgical technique are essential for achieving excellent clinical outcomes.