ABSTRACT
Indications for revision surgery include degenerative disc disease at an adjacent level, with symptoms of radiculopathy, myelopathy, or axial pain that is unrelieved by conservative management. Patients in whom an extension of a preexisting Anterior cervical discectomy and fusion would require a construct spanning four or more levels are generally treated with posterior cervical discectomy and fusion to avoid extensive exposure, with increased risk of injury to the surrounding structures. In patients with significant myelopathy, poor alignment, or concerns for cervical spine instability, awake fiberoptic intubation may be considered, with preintubation and postintubation monitoring obtained. Use of a stand-alone spacer with anchors allows revision at adjacent levels, while minimizing the need for exposure of the preexisting plate and the risk of injuring surrounding structures through dissection and retraction of scar and soft tissue.
