title: Fusion and instrumentation at C1-3 via the high anterior cervical approach.
abstract: OBJECTIVE
  The high anterior cervical, retropharyngeal approach to the anterior foramen magnum and upper cervical spine is a favorable alternative to the transoral and posterolateral approaches, which both cause instability of the craniovertebral junction. Previously, such instability was corrected via an occipitocervical fusion during a separate surgical procedure.
  
  
  METHODS
  Seven patients requiring C-2 corpectomy (foramen magnum meningioma [two patients], critical stenosis secondary to rheumatoid arthritis [two patients], C-2 fracture [two patients], and stenosis secondary to Rickets [one patient]) are presented. All patients underwent C1-3 fusion followed by instrumentation with a Caspar plate. A solid fusion was achieved in six patients. One patient experienced erosion of the anterior arch of C-1 requiring posterior stabilization.
  
  
  CONCLUSIONS
  Fusion and instrumentation at C1-3 can be performed safely and with minimal increase in surgical time. In selected patients, this may eliminate the need for an additional posterior procedure and maintain occipital-C1 mobility.
authors.affiliation: Division of Neurosurgery, Medical College of Georgia, Augusta, USA. jvender@mail.mcg.edu
authors.forename: J R
authors.initials: JR
authors.lastname: Vender
authors.forename: S J
authors.initials: SJ
authors.lastname: Harrison
authors.forename: D E
authors.initials: DE
authors.lastname: McDonnell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*