{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T13:26:58Z","timestamp":1771334818294,"version":"3.50.1"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground<\/jats:title>\nCan we document that posterior cervical surgery (i.e., Laminoforaminotomy (LF) and Laminectomy (L) with Posterior Fusion (PF)) exposes patients to fewer adverse events (i.e., including negligence, multiple risks, negligence, errors, and mistakes) vs. anterior cervical surgery (i.e., Anterior Cervical Diskectomy\/Fusion (ACDF) or Anterior Corpectomy\/Fusion (ACF))?<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nPosterior cervical surgery avoids many of the adverse events uniquely attributed to anterior cervical operations. These include; avoiding fusions with LF vs. ACDF for disc herniations, a lower rate of pseudarthrosis, the avoidance of direct laceration\/indirect traction-related carotid\/jugular vascular and\/or dysphagia\/esophageal injuries, fewer neural\/cord injuries, vertebral artery injuries, and cerebrospinal fluid (CSF) leaks\/dural tears (i.e., particularly with Ossification of the Posterior Longitudinal Ligament (OPLL)).<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nPosterior cervical surgery also poses no direct risks to the following anteriorly-located nerves: recurrent laryngeal nerve (i.e., vocal cord paralysis), phrenic nerve (i.e., diaphragmatic paralysis), the Vagus nerve (i.e., hypotension, reflux, arrhythmias), and sympathetic trunk (i.e., Horner\u2019s Syndrome). However, posterior cervical surgery is generally associated with a higher risk of infection (i.e., 2-10%) vs. anterior surgery (i.e., > 1%), more posterior muscle pain, and a higher risk of kyphosis.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nPosterior cervical surgery exposes patients to many fewer adverse events vs. anterior cervical surgery. We therefore recommend that in appropriately chosen patients, posterior cervical surgical approaches should be chosen over anterior surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_154_2025","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T10:20:36Z","timestamp":1742552436000},"page":"92","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["In the right patient, likely fewer risks with posterior versus anterior cervical spine surgery: Perspective\/short review"],"prefix":"10.25259","volume":"16","author":[{"given":"Nancy E.","family":"Epstein","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Professor of Clinical Neurosurgery, School of Medicine, State University of NY at Stony Brook, NY, USA, and Editor-in-Chief Surgical Neurology International"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc 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