Minimally invasive surgical (MIS) techniques to the spine have focused mainly on the lumbar region. Many reports exist on the ability to decompress the neural structures in the lumbar and thoracic spine both via an anterior and posterior approach. Familiarity with these techniques now allows one or two level interbody and pedicle fusions, and treatment of trauma through MIS approaches. Controversy exists as to the efficacy of these techniques because direct studies comparing MIS approaches with open techniques are lacking. However, proponents of these techniques site smaller incision, less muscle retraction, less blood loss, shorter length of stay and better recovery.

As such, few reports exist on the use of MIS techniques in the cervical spine. Clearly, the anatomic constraints of the cervical spine are different, but they arguably lend themselves more amenable to MIS approaches. We present two cases in which five-level posterior cervical fusion was achieved using a tubular retractor specifically designed for the cervical spine.

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