Fusion of the cervical spine may be done by the anterior approach from the level between the second and third cervical vertebra down through the seventh cervical and first thoracic vertebra. Fusion through the posterior approach may be performed all the way from the skull to the thoracic vertebrae including all or any combination of cervical vertebrae that may be desired. It appears that there are two important indications for fusing the cervical spine: to prevent mechanical irritation of important neural and vascular tissue at sites of bony spur formation between two vertebrae, and to maintain the normal dimensions of the various bone canals in the cervical spine when instability between cervical vertebrae tends to constrict these canals.

The timing, the anaesthesia, and the approach should be considered carefully prior to surgery. Roentgenographic control in the operating room is often essential and always desirable. When dealing with the cervical spine one must remember that the function of the spinal cord, the nerve roots, and the vertebral arteries, with their accompanying sympathetic nerves, is the most important consideration. Surgery on the bone structures of the cervical spine must be designed to protect or improve the function of these enclosed soft tissues.