{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T05:48:09Z","timestamp":1772084889720,"version":"3.50.1"},"reference-count":57,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> To evaluate the applicability and safety of single-stage combined anterior\u2014posterior decompression and fusion for complex cervical spine disorders, the authors retrospectively reviewed 72 consecutive procedures of this type performed using a uniform technique at a single center.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The indications for decompression and stabilization included: postlaminectomy kyphosis (15 patients), trauma (19 patients), spondylosis and congenital stenosis (32 patients), and ossification of the posterior longitudinal ligament (six patients). All patients underwent anterior cervical corpectomies in which allograft fibula and plates were placed, with 89% of patients undergoing two- or three-level procedures (range one\u2013four levels). Lateral mass plating with autograft (morselized iliac crest) fusion was performed in all patients while the same anesthetic agent was still in effect. A hard cervical collar was used postoperatively in all patients (mean 13 weeks). All patients were followed for a minimum of 2 years (mean 29 months).<\/jats:p>\n<jats:p content-type=\"fine-print\">Fusion was determined to be successful in all 72 patients (100%). Although the short-term morbidity rate reached 32%, the significant long-term morbidity rate was only 5%. At the 2-year follow-up examination, anterior cervical plate dislodgment was seen in one patient, and 16 of the 516 lateral mass screws implanted were observed to have partially backed out. However, there were no cases of nerve root injury, strut graft extrusion, or anterior plate or screw fracture. There were no clinically significant hardware complications and no patient required repeated operation.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> The combined single-stage anterior\u2014posterior decompression, reconstruction, and instrumentation procedure represents a viable option in the treatment of a select group of patients with complex cervical spinal disorders. The technique provides immediate rigid stabilization of the cervical spine, prevents anterior plate failure or strut graft extrusion, and eliminates the need for halo immobilization postoperatively. Furthermore, a higher rate of fusion is achieved with this combined approach than with the anterior approach alone.<\/jats:p>","DOI":"10.3171\/spi.2000.93.2.0214","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:49:21Z","timestamp":1241711361000},"page":"214-221","source":"Crossref","is-referenced-by-count":31,"title":["Single-stage anterior\u2014posterior decompression and stabilization for complex cervical spine disorders"],"prefix":"10.3171","volume":"93","author":[{"given":"Karl D.","family":"Schultz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R.","family":"McLaughlin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regis W.","family":"Haid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher H.","family":"Comey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald E.","family":"Rodts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Clin Orthop","first-page":"244","article-title":"Indication, surgical technique, and results of 100 surgically treated fractures and fracture-dislocations of the cervical spine.","volume":"203","author":"Aebi","year":"1986"},{"key":"b2","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00007632-198200710-00001","article-title":"A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine.","volume":"7","author":"Allen","year":"1982"},{"key":"b3","series-title":"Spine","doi-asserted-by":"publisher","first-page":"S501","DOI":"10.1097\/00007632-199110001-00009","article-title":"Failure of halo vest to prevent in vivo motion in patients with injured cervical spines.","volume":"16","author":"Anderson","year":"1991"},{"key":"b4","series-title":"Spine","doi-asserted-by":"publisher","first-page":"S72","DOI":"10.1097\/00007632-199103001-00012","article-title":"Posterior cervical arthrodesis with AO reconstruction plates and bone graft.","volume":"16","author":"Anderson","year":"1991"},{"key":"b5","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"565","DOI":"10.2106\/00004623-196042040-00001","article-title":"Stabilization of the cervical spine by anterior fusion.","volume":"42","author":"Bailey","year":"1960"},{"key":"b6","series-title":"Spine","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1097\/00007632-198903000-00002","article-title":"Comparison of halo complications in adults and children.","volume":"14","author":"Baum","year":"1989"},{"issue":"(221)","key":"b7","series-title":"Clin Orthop","first-page":"149","article-title":"Cervical spondylitic myelopathy and myeloradiculopathy. Anterior decompression and stabilization with autogenous fibula strut graft.","author":"Bernard","year":"1987"},{"key":"b8","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1136\/jnnp.34.4.393","article-title":"The posterior operation in treatment of cervical spondylosis with myelopathy: a long-term follow-up study.","volume":"34","author":"Bishara","year":"1971"},{"key":"b9","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"671","DOI":"10.2106\/00004623-199274050-00006","article-title":"Anterior decompression and arthrodesis of the cervical spine: long term motor improvement. Part I - Improvement in incomplete traumatic quadriparesis.","volume":"74","author":"Bohlman","year":"1992"},{"key":"b10","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"602","DOI":"10.3171\/jns.1958.15.6.0602","article-title":"The anterior approach for removal of ruptured cervical disks.","volume":"15","author":"Cloward","year":"1958"},{"key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3171\/jns.1966.25.1.0057","article-title":"Cervical spondylotic myelopathy.","volume":"25","author":"Crandall","year":"1966"},{"key":"b12","series-title":"Spine","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1097\/00007632-199203000-00001","article-title":"Complications in three-column cervical spine injuries requiring anterior-posterior stabilization.","volume":"17","author":"Cybulski","year":"1992"},{"key":"b13","series-title":"Spine","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1097\/00007632-199301000-00018","article-title":"Clinical validation of functional flexion\/extension radiographs of the cervical spine.","volume":"18","author":"Dvorak","year":"1993"},{"key":"b14","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"421","DOI":"10.3171\/jns.1970.32.4.0421","article-title":"Myelopathy in cervical spondylosis with vertebral subluxation and hyperlordosis.","volume":"32","author":"Epstein","year":"1970"},{"key":"b15","series-title":"Acta Neurochir","first-page":"89","article-title":"A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years.","volume":"61","author":"Epstein","year":"1982"},{"key":"b16","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1097\/00002517-199306050-00011","article-title":"The surgical management of ossification of the posterior longitudinal ligament in 51 patients.","volume":"6","author":"Epstein","year":"1993"},{"key":"b17","series-title":"Clin Neurosurg","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1093\/neurosurgery\/24.CN_suppl_1.488","article-title":"Management of cervical disc lesions and spondylosis by posterior approaches.","volume":"24","author":"Fager","year":"1977"},{"key":"b18","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"341","DOI":"10.3171\/jns.1994.81.3.0341","article-title":"Posterior plates in the management of cervical instability: long-term results in 44 patients.","volume":"81","author":"Fehlings","year":"1994"},{"key":"b19","series-title":"Spine","doi-asserted-by":"publisher","first-page":"S561","DOI":"10.1097\/00007632-199110001-00022","article-title":"Fusion rates in multilevel cervical spondylosis comparing allograft fibula with autograft fibula in 126 patients.","volume":"16","author":"Fernyhough","year":"1991"},{"key":"b20","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"762","DOI":"10.3171\/jns.1986.65.6.0762","article-title":"Complications associated with the halo-vest. A review of 245 cases.","volume":"65","author":"Glaser","year":"1986"},{"key":"b21","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"714","DOI":"10.3171\/jns.1969.30.6.0714","article-title":"Long-term results of surgical treatment of myelopathy due to cervical spondylosis.","volume":"30","author":"Guidetti","year":"1969"},{"key":"b22","series-title":"Spine","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/00007632-198605000-00003","article-title":"Subtotal vertebrectomy and spinal fusion for cervical spondylotic myelopathy.","volume":"11","author":"Hanai","year":"1986"},{"key":"b23","series-title":"Spine","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1097\/00007632-198807000-00011","article-title":"A comparison of anterior cervical fusion, cervical laminectomy, and cervical laminoplasty for the surgical management of multiple level spondylotic radiculopathy.","volume":"13","author":"Herkowitz","year":"1988"},{"key":"b24","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"963","DOI":"10.3171\/jns.1994.80.6.0963","article-title":"Cervical corpectomy and plate fixation for postlaminectomy kyphosis.","volume":"80","author":"Herman","year":"1994"},{"key":"b25","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1097\/00007632-199508000-00016","article-title":"Multilevel cervical spondylosis. Laminoplasty versus anterior decompression.","volume":"20","author":"Hirabayashi","year":"1995"},{"key":"b26","series-title":"Spine","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1097\/00007632-198310000-00003","article-title":"Expansive opendoor laminoplasty for cervical spinal stenotic myelopathy.","volume":"8","author":"Hirabayashi","year":"1983"},{"key":"b27","series-title":"J Bone Joint Surg (Br)","first-page":"609","article-title":"Operations for cervical spondylotic myelopathy. A comparison of the results of anterior and posterior procedures.","volume":"67","author":"Hukuda","year":"1985"},{"key":"b28","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"234","DOI":"10.3171\/jns.1995.82.2.0234","article-title":"One stage internal fixation and anterior fusion in complex cervical spinal disorders.","volume":"82","author":"Johnston","year":"1995"},{"key":"b29","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"217","DOI":"10.3171\/jns.1998.89.2.0217","article-title":"Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament.","volume":"89","author":"Kato","year":"1998"},{"key":"b30","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1227\/00006123-198906000-00012","article-title":"Anterior cervical vertebrectomy and interbody fusion for multi-level spondylosis and ossification of the posterior longtudinal ligament.","volume":"24","author":"Kojima","year":"1989"},{"key":"b31","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1097\/00007632-199308000-00005","article-title":"Anterior cervical plate fixation with the titanium hollow screw plate system.","volume":"18","author":"Kostuik","year":"1993"},{"key":"b32","series-title":"Clin Orthop","first-page":"93","article-title":"Post-laminectomy kyphosis.","volume":"128","author":"Lonstein","year":"1977"},{"key":"b33","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"990","DOI":"10.3171\/jns.1997.86.6.0990","article-title":"Multilevel anterior cervical corpectomy and fibular allograft fusion for cervical myelopathy.","volume":"86","author":"Macdonald","year":"1997"},{"key":"b34","series-title":"Clin Neurosurg","first-page":"543","article-title":"Biomechanics of cervical spine trauma.","volume":"37","author":"Maiman","year":"1991"},{"key":"b35","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1227\/00006123-199105000-00007","article-title":"Cervical spondylotic myelopathy: treatment with posterior decompression and Luque rectangle bone fusion.","volume":"28","author":"Maurer","year":"1991"},{"key":"b36","series-title":"Clin Neurosurg","first-page":"181","article-title":"Cervical spondylosis: a comparison of the anterior and posterior approaches.","volume":"13","author":"Mayfield","year":"1965"},{"key":"b37","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.2106\/00004623-199512000-00001","article-title":"One-stage anterior cervical decompression and posterior stabilization. A study of one hundred patients with a minimum of two years of follow-up.","volume":"77","author":"McAfee","year":"1995"},{"key":"b38","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1097\/00002517-199112000-00010","article-title":"Circumferential fusion for the management of acute cervical spine trauma.","volume":"4","author":"McNamara","year":"1991"},{"key":"b39","series-title":"Spine","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1097\/00007632-198701000-00002","article-title":"Spinal deformity and instability after multilevel cervical laminectomy.","volume":"12","author":"Mikawa","year":"1987"},{"key":"b40","series-title":"Chirurgie","first-page":"702","article-title":"[Anterior plating of the cervical spine with the hollow screw-plate system of titanium.]","volume":"57","author":"Morscher","year":"1986"},{"key":"b41","series-title":"Brain","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1093\/brain\/95.1.101","article-title":"The natural history and the results of surgical treatment of the spinal cord disorder associated with cervical spondylosis.","volume":"95","author":"Nurick","year":"1972"},{"key":"b42","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"352","DOI":"10.2106\/00004623-199173030-00006","article-title":"Treatment of cervical spondylotic myelopathy by enlargement of the spinal canal anteriorly, followed by arthrodesis.","volume":"73","author":"Okada","year":"1991"},{"key":"b43","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1136\/jnnp.36.5.879","article-title":"Surgical treatment of myelopathy with cervical spondylosis.","volume":"36","author":"Phillips","year":"1973"},{"key":"b44","series-title":"The Cervical Spine.","first-page":"390","article-title":"Internal fixation of the unstable cervical spine by posterior osteosynthesis with plate and screws","author":"Roy-Camille","year":"1989"},{"key":"b45","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3171\/jns.1991.74.2.0163","article-title":"Central corpectomy for spondylotic myelopathy: a consecutive series with long-term follow-up evaluation.","volume":"74","author":"Saunders","year":"1991"},{"key":"b46","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"423","DOI":"10.3171\/jns.1961.18.4.0423","article-title":"Cervical spondylosis treated by bilateral facetectomy and laminectomy.","volume":"18","author":"Scoville","year":"1961"},{"key":"b47","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/BF01401131","article-title":"Spondylectomy, microsurgical decompresion and osteosynthesis in the treatment of complex disorders of the cervical spine.","volume":"124","author":"Seifert","year":"1993"},{"key":"b48","series-title":"J of Bone and Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"564","DOI":"10.2106\/00004623-197456030-00014","article-title":"Swan-neck deformity following extensive cervical laminectomy. A review of twenty-one cases.","volume":"56","author":"Sim","year":"1974"},{"key":"b49","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"607","DOI":"10.2106\/00004623-195840030-00009","article-title":"The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion.","volume":"40","author":"Smith","year":"1958"},{"key":"b50","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"45","DOI":"10.2106\/00004623-197759010-00006","article-title":"Fracture-dislocations of the cervical spine. Instability and recurrent deformity following treatment by anterior interbody fusion.","volume":"59","author":"Stauffer","year":"1977"},{"key":"b51","series-title":"Spine","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1097\/00007632-199702010-00009","article-title":"Rigid internal fixation with lateral mass plates in multilevel anterior and posterior reconstruction of the cervical spine.","volume":"22","author":"Swank","year":"1997"},{"key":"b52","series-title":"Clin Orthop","first-page":"71","article-title":"Ossification of the posterior longitudinal ligament of the spine.","volume":"184","author":"Tsuyama","year":"1984"},{"key":"b53","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"635","DOI":"10.2106\/00004623-197355030-00023","article-title":"Brain abscess complicating the use of halo traction.","volume":"55","author":"Victor","year":"1973"},{"key":"b54","series-title":"Spine","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1097\/00007632-198807000-00030","article-title":"Anterior surgery for cervical spondylotic myelopathy. Smith-Robinson, Cloward, and veretebrectomy.","volume":"13","author":"Whitecloud","year":"1988"},{"key":"b55","series-title":"Spine","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1097\/00007632-197603000-00005","article-title":"Fibular strut graft in reconstructive surgery of the cervical spine.","volume":"1","author":"Whitecloud","year":"1976"},{"key":"b56","series-title":"Spine","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1097\/00007632-198510000-00004","article-title":"Choice of surgical treatment for multisegmental cervical spondylotic myelopathy.","volume":"10","author":"Yonenobu","year":"1985"},{"key":"b57","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"170","DOI":"10.2106\/00004623-198971020-00002","article-title":"Cervical kyphosis and myelopathy. Treatment by anterior corpectomy and strut-grafting.","volume":"71","author":"Zdeblick","year":"1989"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/93\/2\/article-p214.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/93\/2\/article-p214.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/93\/2\/article-p214.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:59:13Z","timestamp":1681606753000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/93\/2\/article-p214.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,10]]},"references-count":57,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/spi.2000.93.2.0214","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2000,10]]}}}