Intraoperative computerized tomography scanning to assess the adequacy of decompression in anterior cervical spine surgery

Object. The purpose of this study was to improve the accuracy of bone remov al during anterior spinal surgery. Intraoperative computerized tomography ( CT) scanning was used to assess the success of bone resection and permit Im mediate correction in the event of inadequate bone removal. Methods. The Phillips Tomoscan M was used to obtain preoperative cervical s cans before and after cervical bone resection was complete. The completenes s of bone removal was assessed by the operating neurosurgeon by reviewing t he postresection CT scan. If the bone removal was deemed inadequate, additi onal bone was removed using a high-speed drill. A CT scan was obtained afte r each subsequent decompression until adequate bone removal was achieved. In 31 patients undergoing anterior cervical decompression intraoperative CT scanning was performed. Nineteen patients underwent corpectomy and 12, dis cectomy. Of the 31 patients, assessment of intraoperative CT scans obtained in 17 indicated further bone removal was required. Conclusions. Intraoperative CT scanning to monitor bone removal during ante rior cervical surgery is a valuable tool to ensure the adequacy of surgery.