Anterior cervical spine fusion: struts, plugs, and plates

Bone grafting in the cervical spine is an expanding and rapidly changing area. Its success depends on the presence of bone formation, bone incorporation, and ongoing adaptive remodeling to mechanical loads. The evaluation of anterior cervical spine grafts requires a basic understanding of bone graft physiology, its clinical applications, and its postoperative appearances. The roles of routine radiography, polydirectional tomography, computed tomography, and magnetic resonance imaging in the assessment and follow-up of the postoperatively grafted cervical spine will be discussed. The main focus of this paper is to review current surgical procedures utilized for stabilizing the cervical spine as well as to discuss the radiologist's role in the imaging of this region.