Surgical technique for the protection of the cervical sympathetic trunk in anterolateral oblique corpectomy: A new cadaveric demonstration

Cervical Oblique Corpectomy: Revitalizing the Underused Surgical Approach With Step-By-Step Simulation in Cadavers

“…This study focused on the drilling technique in OC, and is complementary to our previously published study on the securing of the sympathetic chain in OC. 13 We observed that OC can be safely performed, and it is not as difficult a technique as is generally thought, provided that meticulous surgical simulation studies are sufficiently practiced on cadavers in the laboratory. More laboratory work will enable both refinement of the technique and the shortening of the duration of the actual surgery.…”

“…The deep surgical approach up to the vertebral body level will not be mentioned here as it has been described in detail elsewhere. 1,13,23 However, it will be useful to briefly mention the sheltering technique of the sympathetic chain. To protect the sympathetic ganglion and the trunk in actual surgery, an aponeurotic tent is created (Fig.…”

“…We have previously studied and reported the sheltering technique of the sympathetic chain, which is one of the cruces of the OC technique, in human cadavers. 13 However, another crux of the OC technique is the bone drilling style. In order to fill this gap in the published literature, we aimed to simulate the surgical technique of OC step by step in cadavers and to revitalize this underused surgical technique, which, in addition to its clinical benefit, could potentially be costeffective.…”

Letter to the Editor concerning "Anatomic relationship between the cervical sympathetic trunk and cervical fascia and its application in the anterolateral cervical spine surgical approach" by M. Chen et al. (Eur Spine J [2021] 30; 425–430)

“…To the Editor Horner's syndrome can occur as a result of injury to the cervical sympathetic trunk (CST); it is a relatively common complication that causes both functional and cosmetic problems in cervical anterolateral approaches such as oblique corpectomy [1][2][3]. The article, which was recently published in Eur Spine J 30:425-430 by Chen et al [3] demonstrates a surgical technique for securing the CST in cadavers and is therefore very valuable.…”

“…Therefore, it may be difficult to dissect the alar fascia as a separate layer during actual surgery where there is, unlike in anatomical studies, a limited field of view. In fact, the technique of preparing an aponeurotic flap using the prevertebral fascia and placing it for protection by rolling over the CST has been previously reported without explicitly mentioning a separate alar fascia [1,2].…”