Orthopaedics and Trauma
Volume 24, Issue 1 , Pages 74-79, February 2010

Anterolateral approaches to the cervical spine: tips and tricks

Luca Denaro MD PhD Consultant in Neurosurgery, Department of Neuroscience, University of Padua, Padua, Italy

Umile Giuseppe Longo MD Resident in Trauma and Orthopaedic Surgery, Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Rome, Italy

Nicola Maffulli MD MS PhD FRCS(Orth) Professor of Trauma and Orthopaedic Surgery, Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, UK

Vincenzo Denaro MD Professor of Trauma and Orthopaedic Surgery, Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Rome, Italy

Abstract 

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.

Keywords: anterolateral approaches, cervical spine, exposure, surgery

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PII: S1877-1327(09)00146-8

doi:10.1016/j.mporth.2009.09.002

Orthopaedics and Trauma
Volume 24, Issue 1 , Pages 74-79, February 2010