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COMPLICATIONS AND LIMITATIONS OF ANTERIOR DECOMPRESSION AND FUSION OF THE CERVICAL SPINE (CLOWARD'S TECHNIQUE) 1
Author(s) -
Selecki A. R.
Publication year - 1971
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1971.tb92817.x
Subject(s) - medicine , surgery , myelopathy , complication , decompression , cervical spondylosis , deformity , spinal canal stenosis , stenosis , spinal canal , anterior cervical discectomy and fusion , spinal stenosis , radiological weapon , cervical spine , radiology , spinal cord , alternative medicine , pathology , psychiatry , lumbar
Cloward's operation has been the major advance in the surgical treatment of the cervical spinal conditions established during the last decade. Limitations of its application in cervico‐brachialgia, in myelopathy secondary to spondylosis, in fracture‐dislocations of the cervical spine and complications due to technical problems are discussed. The operation is most suitable for conditions involving the lower cervical levels only. Partial collapse of the fused vertebral bodies or of the graft with resulting kyphotic deformity is the most commonly encountered complication, of primarily radiological and no clinical consequence in our experience. Graft extrusion is the most common complication in fracture‐dislocation, and plating may be required to prevent this. Plating in itself presents a technically difficult problem. Anterior interbody fusion has little to offer in head and neck pain, as well as in myelopathy secondary to multi‐level spondylitic changes involving also the upper cervical segments, or secondary to canal stenosis. It is further implied that the procedure is contraindicated in fracture‐dislocations which have occurred in extension. The experience with the limitations and complications related to this operation allows for a clearer definition of its prominent place in the treatment of cervical spinal conditions.