P018: How I Do It: Anterior Approach to the Cervical Spine

Abstract

The anterior approach to the cervical spine is an optimal procedure for access in surgery for cervical spine disease. First described in 1950, this procedure has proven to be reliable and continues to gain popularity in both neurosurgical and orthopedic practice. In recent years, otolaryngologists are increasingly called upon to perform or assist in exposure of the cervical spine, especially for cases involving revision procedures. A comprehensive Medline search and review of otolaryngology surgical references, however, revealed that little has been published in the otolaryngology literature to describe a safe and effective technique for performing this increasingly important surgical procedure. We report our experience with patients requiring spine exposure by this approach and describe a reliable technique for exposure of the anterior cervical spine.Methods: We present our experience in 30 consecutive patients who underwent an anterior approach to the cervical spine for primary neurosurgical and orthopedic procedures. Furthermore, we review the literature regarding this approach with special consideration of the anatomy and potential complications reported in literature.Results: Our results reveal no permanent complications attributable to this procedure, without any instances of recurrent laryngeal nerve injury or hematoma. Immediate complaints of incisional pain resolve, and long-lasting cutaneous numbness is ultimately well tolerated. Conclusion:The anterior approach to the cervical spine is a safe and effective technique for exposure of the cervical spine and is the procedure of choice for surgical manipulation in the treatment of anterior cervical spine disease.