State of the art approaches for treating cervical spine pathologies
Süvegh Dávid
Surgical Medicine Division
Dr. Szijártó Attila
Budapesti Dr. Manninger Jenő Baleseti Központ, Fiumei út 17, 1081 Budapest
2026-04-08 14:00:00
Physiology and Pathology of the Musculoskeletal System
Dr. Szőke György
Dr. Viola Árpád
Dr. Novák László
Dr. Veres Róbert
Dr. Bodzay Tamás
Dr. Valálik István
Dr. Nyáry István
This dissertation presents innovative surgical methods aimed at enhancing patient safety and clinical outcomes in the management of complex cervical spine pathologies. Two novel surgical approaches are extensively discussed and evaluated. The first approach, the microscope-assisted minimally invasive anterior submandibular retropharyngeal key-hole (MIS ASR) technique, was introduced to facilitate ventral decompression at the craniocervical junction. Avoiding a transmucosal pathway to the atlanto-axial region, this approach significantly reduces the risks associated with traditional decompression methods, such as cerebrospinal fluid leakage and velopharyngeal insufficiency, while enabling rapid postoperative recovery and avoiding the need for tracheostomy. Clinical outcomes from initial case series demonstrated that this minimally invasive approach was feasible, safe, and effective in carefully selected patients, with substantial neurological improvements observed postoperatively. The second surgical method evaluated cervical plate stabilization combined with polymethyl methacrylate (PMMA) bone cement augmentation for treating unstable subaxial cervical spine fractures in patients with ankylosing spondylitis (AS). This technique successfully provided robust structural stability without the need for posterior fixation. Despite the complexity and the severe comorbidities of AS patients, the approach demonstrated favourable outcomes with respect to structural stability, improved or preserved neurology, and acceptable mortality rates when compared to traditional fixation methods. Overall, while the initial findings from both approaches are promising, further prospective studies with larger patient populations are necessary to fully establish their long-term efficacy and safety, and to refine these surgical techniques.
