The application of a radiographically determined ratio as a new technique to identify the optimal level of transverse skin incision for anterior cervical spine surgery.
A transverse skin incision for anterior cervical spine surgery gives an excellent cosmetic result but is not extensile, thus accuracy of incision placement is essential. We describe a new, fast and inexpensive method of accurate transverse skin incision placement that does not rely on anatomical landmarks or intraoperative fluoroscopy. A ratio, determined by measurements from a lateral cervical spine radiograph, was applied to measurements on the patients' neck to determine the site for incision. The use of a ratio was designed to remove any inaccuracies related to X-ray magnification differences. A retrospective review of 54 consecutive anterior cervical spine procedures undertaken with this technique was performed. The operative level ranged from C2-C3 to C7-T1, the most common being C5-C6. Post-operative radiographic measurement of the incision site (marked by skin clips) demonstrated a mean distance of 5 mm (range 1-8 mm) from the centre of the skin clips to the predetermined ideal midpoint for each individual. In no case was it necessary to radically extend or to make a separate incision. The technique described is an accurate method of determining the level of transverse skin incision placement for cervical spine surgery that reduces intra-operative fluoroscopy time, radiation dose and expense.
Department of Trauma and Orthopaedic Surgery, University College Hospital, Newcastle Road, Galway City (G1), County Galway, Ireland. mikeleonard77@gmail.com
Michael
M
Leonard
Cian
C
Kennedy
Helen
H
Heneghan
John Mc
JM
Cabe
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D017586:Diskectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012867:Skin / Q000033:anatomy & histology; D013123:Spinal Fusion; D013131:Spine / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D059145:Total Disc Replacement; D016896:Treatment Outcome