Anterior approach to the subaxial cervical spine in children: a brief review
HE anterior approach to the cervical spine, the technique originally developed and described by Smith and Robinson, 27 Cloward, 10 and Bailey and Badgley 3 in the late 1950s and early 1960s for treatment of cervical disc herniations and spondylotic myelopathy in the adult population, has proven to be quite useful for select indications in children. This approach has been used for correction of congenital, traumatic, and iatrogenic deformity of the cervical spine; to treat cervical disc
... ns; and for the surgical management of tumors. Similar surgical strategies in terms of the approach and surgical decision making apply to the pediatric as well as to the adult population. Differences, however, arise when one takes into consideration the fact that the pediatric cervical spine continues to grow from childhood into adolescence, and that standard spinal instrumentation may have too large a profile for general pediatric use. We review the indications for an anterior cervical approach in the pediatric spine and discuss bone grafting, instrumentation, and bioabsorbable technology in relation to the pediatric population. Neurosurg. Focus / Volume ߜ Although it was originally developed to address degenerative problems, including disc herniations and cervical spondylotic myelopathy in the adult population, the anterior approach to the subaxial spine has proven to be useful for select indications in the pediatric population. The authors review indications for surgery, bone grafting, and instrumentation as they pertain to children. KEY WORDS • anterior cervical approach • bone graft • children 1 Abbreviations used in this paper: ACDF = anterior cervical discectomy and fusion; AP = anteroposterior; BMP = bone morphogenetic protein; CT = computerized tomography; PEEK = polyetheretherketone; VB = vertebral body.