Combination of the Williams–Isu method and the transvertebral approach to treat cervical disease

In anterior fusion, we use autologous bone grafts from cervical vertebral bodies (Williams–Isu method; WI-method). To reduce the fusion level, we combine the WI-method and the transvertebral approach (TVA). The wide window yielded by the removal of the bone graft from vertebral bodies at the fusion level provides for the safe decompression of neural structures. Further decompression with TVA is performed from the wide window to the adjacent level. After a two-level decompression, anterior fusion at one level is performed by autologous bone grafting. We subjected 20 patients with cervical disease to this approach. All recovered from their symptoms without surgical complications and in all patients we confirmed fusion and the retention of mobility at the TVA level. The wide operative field yielded by the WI-method is an advantage when the procedure is combined with TVA, and this technique is less invasive in patients with multilevel cervical disease.