Posterior Cervical Fusion with Local Anesthesia: The Awake Patient as the Ultimate Spinal Cord Monitor

A technique is described for posterior cervical stabilization with wire and fusion using iliac crest bone graft, performed under local anesthesia. Thirty-four consecutive cases performed at Rancho Los Amigos Medical Center are reviewed. In patients with unstable cervical spines and variable degrees of neurologic injury, posterior stabilization and fusion using local anesthesia allows the patient to interact with the surgeon during crucial moments of spinal manipulation. The technique is well tolerated by patients, and no untoward complications have occurred with use of this technique.