title: Artificial pedicle screw reconstruction of the cervical spine after lateral paramedian transpedicular approach for lesions of the ventral cervical spinal canal.
abstract: OBJECTIVE
  We describe in detail the anatomic and surgical principles of a lateral cervical paramedian transpedicular approach, a novel technique that provides access to the ventral cervical spinal canal. We also describe single-stage posterior column reconstruction of the cervical spine in which traditional cervical lateral mass screws are used simultaneously to reconstruct the cervical pedicle and to allow for three-column stabilization in a continuous posterior screw-rod construct after this approach.
  
  
  METHODS
  This technique is a modification of traditional thoracic posterolateral extracavitary approaches and has been used by our group for the resection of intradural and extradural spinal lesions, as we illustrate.
  
  
  RESULTS
  This approach is particularly useful in cases where significant pathological characteristics of the trachea or esophagus preclude an anterior approach to the cervical spine and in cases in which multiple levels are involved.
  
  
  CONCLUSIONS
  Cervical spinal stability is enhanced, because all cervical levels are incorporated into the final screw-rod construct.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, California 94143-0112, USA.
authors.forename: Frank L
authors.initials: FL
authors.lastname: Acosta
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Ames
mesh_terms: D000328:Adult; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008279:Magnetic Resonance Imaging / Q000379:methods; D008953:Models, Anatomic; D011182:Postoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D012306:Risk; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000601:surgery