Radiologic evaluation of surgical cervical spine fusion

Preoperative, intraoperative, and postoperative radiologic evaluation of surgical cervical spine fusion plays an integral part in the management of cervical spine injuries. The radiographic anatomy of the basic types of anterior, posterior, and combined fusions and the indications for their performance are discussed. A retrospective review of 210 consecutive cervical spine fusions showed a 21.1% radiographic complication rate for anterior fusions and only 3.9% for posterior fusions. The high complication rate of anterior fusions is related to the performance of anterior fusion in the presence of unrecognized posterior instability. Radiographically identified complications must be correlated with the clinical neurologic examination in each case since the spectrum of radiographic complications may be compatible with a clinically satisfactory result.