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.
D-TRAX at C6–7 following ACDF pseudarthrosis (MP4 349130 kb)
- 5.Smith W, Gillespy M, Huffman J, Vong V, McCormack BM. Anterior cervical pseudarthrosis treated with bilateral posterior cervical cages. Oper Neurosurg. 2017. https://doi.org/10.1093/ons/opx103.
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