Minimally invasive posterior cervical fixation

Posterior fixation techniques continue to play a vital part in the treatment of cervical spine pathology. Evolving from semirigid techniques such as wiring to dynamic screw-plate constructs, modern techniques employing screw rod constructs now allow for far more robust stabilization after cervical decompression. Additionally, interfacet and transfacet techniques have further added to the armamentarium available to surgeons to achieve rigid arthrodesis and maintainance of correction. With the implementation of minimally invasive tissue-sparing techniques during posterior cervical instrumentation, significant improvements in soft tissue morbidity, blood loss, pain, recovery, return to work, infection, and reoperation rates have also been observed and documented. Contemporary three-dimensional intraoperative imaging techniques also provide enhanced accuracy and localization during instrumentation of the posterior cervical anatomy. When used with newer perioperative pharmaceutical and anesthetic protocols as well as with modern intraoperative neurmonitoring modalities such as motor evoked potentials, the combination of these surgical technologies has served to greatly enhance the efficacy, safety, accuracy, and outcomes of posterior surgical decompressive and instrumentation procedures.