Instrumentation Strategies and New Technologies in Treating Cervical Spine Tumors.

STUDY DESIGN: Narrative review. OBJECTIVE: This paper summarizes instrumentation strategies and emerging technologies for the treatment of cervical spine tumors. SUMMARY OF BACKGROUND DATA: The management of cervical spine tumors involves unique challenges due to inherent anatomic differences between the cervical spine compared with the remainder of the spine. Existing and emerging technologies, such as CT-based navigation, robotic-assisted surgery, ultrasound, and augmented reality, allow for increased efficiency and efficacy with instrumentation and surgical decompression. METHODS: A thorough review of the cervical spine oncologic literature was performed using the PubMed database, and articles addressing the topic of instrumentation strategies and emerging technologies were included within the narrative review. RESULTS: Cervical spine approaches in the oncologic patient involve a multidisciplinary approach, careful consideration of the patient's systemic disease, and thorough anatomic and preoperative imaging review. Depending on the approach and extent of resection and expected structural instability, reconstruction methods vary from anterior-based, posterior-based, and circumferential. The unique considerations of the oncologic spine inform implant, graft, and reconstruction choice. Use of neuronavigation and, increasingly, robotic systems provides safe and beneficial adjuncts to the operative workflow. Future directions in cervical oncologic surgery include patient-specific implant design, artificial intelligence and machine-learning-based models, and augmented and mixed-reality systems to aid in intraoperative decision-making and navigation. CONCLUSIONS: Existing reconstruction and navigation technologies provide safe and accurate tools for cervical spine reconstruction after tumor resection. With improved systemic disease control, future surgical innovations may enhance intraoperative workflow, minimize imaging artifacts, and improve postoperative fusion in oncologic patients.