Anterior intervertebral-body fusion has been advocated by various
authors for management of several varieties of fracture and
fracture-dislocation of the cervical spine. This report is a retrospective
study of sixteen patients, all of whom had a fracture-dislocation of the
cervical spine, who were treated with an anterior dowel interbody fusion.
All had postoperative instability with recurrence of angular deformity, and
all sixteen were shown to have disruption of the posterior ligaments. Three
patients had a progressive neurological deficit postoperatively. Thirteen
patients required two or more operative attempts at stabilization. Anterior
fusion should not be performed as primary surgical treatment for fractures
of the cervical spine when there is either evidence of disruption of the
posterior ligaments or a strong presumption that such disruption
exists.