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Microscopic Anterior Cervical Decompression

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Cervical Spine Surgery: Standard and Advanced Techniques

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Abstract

Anterior cervical procedures have become the gold standard since the description of Smith, Robinson and Cloward in the 1960s. Surgical treatment is indicated when prior conservative therapy has failed or progressive symptoms are present. Preoperative CT and MRI images are accomplished to determine bony or discoligamentous neural compressions. The patient is placed in a supine position: a right-sided approach prior to fluoroscopic control is recommended. The skin is incised at the median border of the sternocleidomastoid muscle ending across the midline. The subcutaneous tissue is undermined with longitudinal platysma split, and the subplatysmal space and the neck fasciae are accessed bluntly. After identifying the longus colli muscles, the retractors are placed.

The discectomy is performed with microscope support down to the PLL using high-speed drills and Kerrison rongeurs to achieve neural decompression. Strut grafting using synthetic materials filled with fusion-promoting agents or local bone is carried out under fluoroscopic control. Additionally, a screw/plate system might be used.

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Authors and Affiliations

  1. Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria

    Sebastian Hartmann, Anja Tschugg & Claudius Thomé

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  1. Sebastian Hartmann
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  2. Anja Tschugg
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  3. Claudius Thomé
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Correspondence to Sebastian Hartmann .

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Editors and Affiliations

  1. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Heiko Koller

  2. Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

    Yohan Robinson

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Hartmann, S., Tschugg, A., Thomé, C. (2019). Microscopic Anterior Cervical Decompression. In: Koller, H., Robinson, Y. (eds) Cervical Spine Surgery: Standard and Advanced Techniques. Springer, Cham. https://doi.org/10.1007/978-3-319-93432-7_48

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  • DOI: https://doi.org/10.1007/978-3-319-93432-7_48

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93431-0

  • Online ISBN: 978-3-319-93432-7

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