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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 3/2011

01-03-2011 | Symposium: Current Concepts in Cervical Spine Surgery

Cervical Spine Surgery: An Historical Perspective

Authors: Vincenzo Denaro, MD, Alberto Di Martino, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2011

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Abstract

Background

Continued innovation in surgery requires a knowledge and understanding of historical advances with a recognition of successes and failures.

Questions/purposes

To identify these successes and failures, we selectively reviewed historical literature on cervical spine surgery with respect to the development of (1) surgical approaches, (2) management of degenerative disc disease, and (3) methods to treat segmental instability.

Methods

We performed a nonsystematic review using the keywords “cervical spine surgery” and “history” and “instrumentation” and “fusion” in combination with “anterior approach” and “posterior approach,” with no limit regarding the year of publication. Used databases were PubMed and Google Scholar. In addition, the search was extended by screening the reference list of all articles.

Results

Innovative surgical approaches allowed direct access to symptomatic areas of the cervical spine. Over the years, we observed a trend from posterior to anterior surgical techniques. Management of the degenerative spine has evolved from decompressive surgery alone to the direct removal of the cause of neural impingement. Internal fixation of actual or potential spinal instability and the associated instrumentation have continuously evolved to allow more reliable fusion. More recently, surgeons have developed the basis for nonfusion surgical techniques and implants.

Conclusions

The most important advances appear to be (1) recognition of the need to directly address the causes of symptoms, (2) proper decompression of neural structures, and (3) more reliable fusion of unstable symptomatic segments.
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Metadata
Title
Cervical Spine Surgery: An Historical Perspective
Authors
Vincenzo Denaro, MD
Alberto Di Martino, MD, PhD
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 3/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1752-3

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