Rapid advance in technology and research and its application to spinal surgery has made dramatic alterations in approach to pathology in the spine. From standard laminectomy and interbody fusions using autologous grafts, the scenario has changed quickly to minimally invasive techniques, use of bone substitutes and implants and finally application of newer trends of motion preserving surgery.

Spinal surgery is lacking in the trail of rich past experience which has to be looked upon for guidance. Trust in the newer ideas, thus, has to be empirical. Even today most doctors and patients are conservative in their attitude and fear visionary innovations and newer ideas. If one is committed to progress, then trust in the newer ideas is absolutely essential. It is generally accepted that larger the risk, higher is the intellectual devotion and commitment to the cause.

As a sequela to better health care and increased life expectancy one is now obliged to see a plethora of pathological problems associated with degeneration of the aging spine. Surgery on them could be challenging in view of problems associated with getting old. All the same, innovative methods when applied judiciously can go a long way in giving much desired comfort to those who are at the fag end of their life.

As an aftermath of advance in technology, the market is flooded with implants that are being promoted with cut-throat competition. If knowledge is to be applied with wisdom, then insight into the basic steps in spinal surgery is absolutely essential.

Clinical materials one abundant worldwide. Imaging has improved tremendously. Quickly pinpointing the source of pain in the neck has become easy. The treatment then should be decided on the basis of a rational approach based on knowledge, wisdom and past experience. Surgeons familiar with one approach should now have an open mind to alternative safer techniques and they should foresee predicted outcomes.

It is hoped that this book will not only give knowledge but infuse much desired confidence in all the spinal surgeons who follow this book step by step in giving better service to spine ailing patients.

I have been working in this field since 1965 and perhaps in this specialty since its inception. I have seen it during its primitive days, I have seen it grow and now I am seeing it matured. With my experience of over 43 years, I wanted to convey to others what I personally saw and what I personally practiced. With this view in mind several years back I had started working on this project as I wanted to write the full text myself.

Under pressure from my publishers, “Jaypee Brothers” from New Delhi, I had to complete some work. I decided to publish the first volume on cervical spine surgery.

I propose to complete the next volume on lumbar and thoracic spine soon.

With lot of goodwill, the cooperation for this work was pouring in from all corners.

I would like to sincerely acknowledge the cooperation of Dr Motoi Shoda, Japan, for his timely assistance, suggestions and guidance. I sincerely thank Dr A Menezes and Dr S Rengachari from USA for their valuable guidance. I also thank Dr Hafid Bajamal from Indonesia for his encouragement. I express my special thanks to Dr Sushil Patkar, Pune, for his contribution, suggestions and obedience.

I sincerely thank all my colleagues, residents, fellows and students (past and present) who in addition to performing their official duties in a busy department, helped me to give finishing touches to this work. I would especially like to thank Dr Alok Sharma, Mumbai; Dr Kailai Raja, Madurai; Dr JKBC Parthiban, Chennai; Dr Yashbir Dewan, Punjab; Dr Adil Chhagla, Mumbai; Dr Shrikant Rege, Indore; Dr Prasad Patgaonkar, Mumbai, and Drs Bhatuk, Shradha, Antonio, Sanjay, Prasad, Samir, John Ebnezar and many many more. I thank my sister's in the operation theater Ancy, Shakuntala, Kalpana and others for their prompt cooperation. Mrs Priya Bhat my computer secretary has been working very hard late hours in the night since I received notice from the publishers. Without her cooperation this work could not have taken shape. My sincere thanks go to Shailesh, artist and photographer, who delivered very promptly whatever work I assigned to him. I cannot complete this list without remembering my staff Santosh, Swati and Ajit who cooperated with love even working late at night.

To all of you my salute for the sincere and enthusiastic zeal with which you worked to see this volume take shape.