• Clifford Crutcher
  • Anthony Digiorgio
  • Remi Nader
  • Gabriel Tender


Minimally invasive approaches have been extensively used in the lumbar spine, but less so in the cervical spine. Open posterior cervical approaches are particularly morbid, since the paraspinous muscles have to be detached from the spinous processes and laminae all the way out to the lateral edge of the lateral facets. The D-TRAX procedure has emerged as a great minimally invasive option in patients who need a posterior cervical fusion without a laminectomy. Besides the obvious advantages of minimally invasive approaches, the D-TRAX procedure also seems to provide very high fusion rates, since the bone only needs to grow over a few mm and the cage is under axial loading, favoring Wolff’s law. Moreover, the cages distract the facet joints in a parallel fashion, and thus there is no loss of lordosis after this procedure. Finally, the biomechanical stability offered by the D-TRAX cages appear to be similar to that offered by the lateral mass screws/rods constructs.

Supplementary material

Video 19.1

D-TRAX at C6–7 following ACDF pseudarthrosis (MP4 349130 kb)


  1. 1.
    McCormack BM, et al. Percutaneous posterior cervical fusion with the DTRAX facet system for single-level radiculopathy: results in 60 patients. J Neurosurg Spine. 2013;18:245–54. Scholar
  2. 2.
    Voronov LI, et al. Bilateral posterior cervical cages provide biomechanical stability: assessment of stand-alone and supplemental fixation for anterior cervical discectomy and fusion. Med Devices. 2016;9:223–30. Scholar
  3. 3.
    Voronov LI, Siemionow KB, Havey RM, Carandang G, Patwardhan AG. Biomechanical evaluation of DTRAX((R)) posterior cervical cage stabilization with and without lateral mass fixation. Med Devices. 2016;9:285–90. Scholar
  4. 4.
    Leasure JM, Buckley J. Biomechanical evaluation of an interfacet joint decompression and stabilization system. J Biomech Eng. 2014;136:071010. Scholar
  5. 5.
    Smith W, Gillespy M, Huffman J, Vong V, McCormack BM. Anterior cervical pseudarthrosis treated with bilateral posterior cervical cages. Oper Neurosurg. 2017.
  6. 6.
    Skovrlj B, Qureshi SA. Minimally invasive cervical spine surgery. J Neurosurg Sci. 2017;61:325–34. Scholar
  7. 7.
    Siemionow K, Monsef JB, Janusz P. Preliminary analysis of adjacent segment degeneration in patients treated with posterior cervical cages: 2-year follow-up. World Neurosurg. 2016;89(730):e731–7. Scholar
  8. 8.
    Siemionow K, et al. Clinical and radiographic results of indirect decompression and posterior cervical fusion for single-level cervical radiculopathy using an expandable implant with 2-year follow-up. J Neurol Surg A Cent Eur Neurosurg. 2016;77:482–8. Scholar
  9. 9.
    Siemionow K, Janusz P, Glowka P. Cervical cages placed bilaterally in the facet joints from a posterior approach significantly increase foraminal area. Eur Spine J. 2016;25:2279–85. Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Clifford Crutcher
    • 1
  • Anthony Digiorgio
    • 1
  • Remi Nader
    • 2
    • 3
    • 4
    • 5
    • 6
  • Gabriel Tender
    • 7
  1. 1.Department of NeurosurgeryLouisiana State University Health Sciences CenterNew OrleansUSA
  2. 2.Texas Center for Neurosciences PLLCHoustonUSA
  3. 3.American Board of Neurological SurgeryChicagoUSA
  4. 4.Department of NeurosurgeryUniversity of Texas Medical BranchGalvestonUSA
  5. 5.William Carey UniversityHattiesburgUSA
  6. 6.Department of NeurosurgeryTulane UniversityNew OrleansUSA
  7. 7.Louisiana State UniversityNew OrleansUSA

Personalised recommendations