[Technic of ventral spondylodesis of the lower cervical spine]

Anterior fusion of the lower cervical spine is usually performed without difficulty. The surgical technique is simple and normally involves little risk. The indication and technique depend completely on the clinical picture; otherwise, the results are unavoidably poor. A slipped cervical disc is operated on using the Smith-Robinson or Cloward procedure. If extensive decompression with resection of dorsal osteophytes is required, the Cloward technique is preferable due to the superior view of the spinal canal. In dislocations or dislocation fractures of the cervical spine requiring decompression and fusion from the anterior approach, the spine should be stabilized with a bone graft and plate. An anterior approach increases the instability due to damage to the posterior ligaments in flexion injuries. Fusion is usually performed with autologous iliac or fibular grafts, which show good ingrowth but different load-bearing properties. Multisegmental fusions or defects following tumor resections can be bridged with deep-frozen homologous grafts. To achieve immediate stability PMMA implants may be necessary. Implants of bioactive glass ceramics may prove useful in the future.