Anterior cervical instrumentation

A review of the history, indications, techniques, and complications of anterior cervical instrumentation is presented from both the available literature and the senior author's experience. Factors that determine an ideal anterior cervical instrumentation system are addressed. Special attention is given to the indications for anterior cervical fixation in cervical degenerative disorders, including multisegmental or long-segmental fusion in patients with multilevel spondylosis or ossification of the posterior longitudinal ligament. The more common pitfalls in the use of both unicortical and bicortical systems as well as graft and graft receptor sire preparation are presented. Current directions in improvements in both biomechanical and biocompatible design of anterior cervical instrumentation are discussed.