ANTERIOR AND ANTERO-LATERAL SURGERY OF TH E LOWER CERVICAL-SPINE - (25 YEARS AFTER VERBIEST,H.) .2. INDICATIONS, RESULTS, COMPLICATIONS

The present course on the anterior and antero-lateral surgical approac h of the lower cervical spine was organized for the neurosurgery train ees by the French Speaking Neurosurgical Society, and was held during the winter meeting in December 1995. The aim of this course was to rec all the basic technical principles of the microsurgical anterior cervi cal approach, and to discuss the main indications of this surgical tre atment. Many theoretical points were strengthened by the author's pers onal experience and comments. In Part I? the technical bases of the di fferent anterior or antero-lateral approaches were presented (1996, 42 : 105-122). In the present Part II, the main indications of the anter ior surgical approach to the cervical disk or the vertebral body are d etailed, and the requirement of a bone graft and/or an osteosynthesis are discussed with their consequences on the final results, Secondly, variants of the surgical technics in use in case of cervical spinal in stability are commented. Then various approaches to the cervical spina l tumors and to the vertebral artery are detailed and commented. Lastl y, general and specific complications of the anterior cervical approac h are listed with their rate of occurrence, and their prevention and m anagement are discussed.