New instrument for creating bone graft cavities for anterior cervical decompression and fusion: the anterior fusion spinal fork.

Sufficient bone decompression of osteophytes is important for positive functional outcomes in anterior cervical spine surgery. Achieving good alignment and bone fusion in anterior cervical decompression and fusion requires a bone graft bed of the optimum size and shape. We have developed a stainless steel instrument named the anterior fusion spinal fork, which is designed to aid in accurately drilling the bone cavity, thus enabling selection of the correct size of bone graft or bone graft substitutes. The device has an open design with 4 prongs, and resembles a three-dimensional fork. This instrument assists in guiding the direction of drilling, and marking the drilling point of the graft cavity with pyoctanin markers. We have used this instrument in 40 cases of anterior cervical spine surgery using the modified Smith-Robinson procedure since March 2000. This simple instrument allowed us to design and construct a bone graft cavity of the correct size and shape for iliac bone graft or bone graft substitutes for anterior cervical spine surgery.