What is Minimally Invasive Posterior Cervical Fusion (MIS PCF)?
What is Minimally Invasive Posterior Cervical Fusion (MIS PCF)?
Minimally Invasive Posterior Cervical Fusion (MIS PCF) is a way of stabilizing vertebrae in the neck through small 1cm incisions. Traditional open posterior cervical fusion is achieved through a midline incision and requires dissection and detachment of cervical paraspinal muscles from their attachments to the bones of the cervical spine. The bones are stabilized with screws and rods until a bridge of bone or fusion can form between the bones. Open posterior cervical fusion with lateral mass screws and rods has been around since the early 1980s and is a very effective technique to achieve fusion. The major drawback is that the dissection required to place these screws causes significant postoperative pain and makes for a longer recovery.
Surgical exposure for traditional, open posterior cervical spine surgery. After exposure screws and rods are inserted to provide stability for fusion.
MIS PSF, first introduced in the early 2010s (McCormack et al, JNS: Spine, 2013), achieves the same goal of stabilization and fusion of cervical vertebrae through a posterior approach with far less soft tissue damage. MIS PCF is achieved through one or two 1cm incisions in the back of the patient’s neck and does not require dissection or detachment of the important cervical paraspinal muscles from the bones in the cervical spine.
Surgical incision for MIS PCF
Who is a candidate for MIS PCF?
The purposes of MIS PCF is to increase the likelihood of successful fusion in the cervical spine. Patients with high risk of failure of spinal fusion may benefit from MIS PCF.
There are two major categories of patients who benefit the most from MIS PCF:
1)Patients undergoing Anterior Cervical Discectomy and Fusion (ACDF) with a high risk for pseudarthrosis (failure of fusion)
Risk factors for pseudarthrosis (failure of fusion) include but are not limited to: smoking or tobacco use, diabetes, osteoporosis, multilevel fusion, chronic steroid use
2)Patients with symptomatic pseudarthrosis after ACDF
MIS PCF Patient Testimonial
Followup PA and Lateral Xray of high risk cervical fusion patient who underwent MIS PCF.
Not all patients are appropriate candidates for MIS PCF and there are situations other than those described above who may benefit from MIS PCF. The decision to perform MIS PCF or any spine surgery is complex and requires review of patient history, physical examination, medical imaging, and a collaborative discussion between the patient and either an Orthopedic Surgeon or Neurosurgeon with specialized training in spine surgery.
