Microsurgical approach to the anterior cervical spine and spinal cord

When the cervical spine is affected by disease that is predominantly anterior, we prefer to take an anterior operative approach. Whether or not fusion is indicated depends largely upon the case. In general, we do not fuse the spine unless it is unstable. Widening of the spinal canal and the neural foramina can be done effectively by the anterior route, with or without anterior fusion. When the spine is unstable from disease affecting the vertebral bodies, we routinely fuse with bone graft or provide mechanical stability with a vertebral body prosthesis if life expectancy is short.