Chapter 135 - Anterior Approaches for Multilevel Cervical Spondylosis

Abstract

Cervical spondylosis is an increasingly diffuse condition that ranges in severity from a simple and common phenomenon of ageing to a picture as complex as spastic tetraparesis in a setting of neglected degenerative worsening or superimposition of a traumatic event on a structural already critical condition. Besides neck and arm pain and the ensuing functional limitations, which are the hallmark of symptomatic cervical spondylosis, myelopathy due to spinal cord compression is the single most threatening condition that needs to be addressed in the realm of cervical spondylosis. Surgical treatment is generally the only effective therapeutic intervention in order to release the spinal cord from a compromised condition of mechanical compression and the risk of sudden deterioration. While current research and new insights keep on changing the indications, timing, and modalities of intervention, anterior multilevel cervical approaches are still today the most frequently adopted procedure to reverse a multisegmental cervical cord compression. After an introduction with new insights in the current understanding and management of this challenging condition, this chapter illustrates the surgical options and techniques for a successful restoration of spinal and root canal dimensions over multiple segments in the cervical spine via the anterior approach.