Cervical spine surgery: anterior microsurgery.

Anterior cervical decompression and fusion is one of the most commonly used procedures to treat myelopathy and radiculopathy. With the addition of the surgical microscope, enhanced visualization of the microanatomy has allowed the safe and efficient treatment of compressive pathology. It is important to understand the critical steps required to successfully treat cervical spine pathology from an anterior approach with the assistance of a surgical microscope, the factors involved in choosing a decompressive method, the technical considerations for intervertebral grafting, and the use of cervical plating. The knowledge of surgical pearls may optimize spinal cord and nerve root decompression, increase fusion rates, and give patients the best chance for a successful clinical outcome.