Anterolateral approaches to the cervical spine: tips and tricks

The most common anterolateral approaches to the cervical spine are the low and high presternocleidomastoid approaches, which allow exposure of all levels of the cervical spine, from the base of the skull to the upper thoracic vertebrae. Proper positioning of the patient is a key point to gain good operative exposure and to prevent the potential complications of excessive pressure on neural or vascular structures. This is an important aspect of cervical spinal surgery, because of the depth and relative inaccessibility of the structures, the required accuracy for the determination of level and the inherent risks of the positions themselves. We describe the common anterolateral approaches to the cervical spine, complications, and some tips and tricks to avoid them.