title: Anterolateral approach to the upper cervical spine: Case report and operative technique.
abstract: BACKGROUND
  Transcervical approaches to the upper cervical spine are challenging because several upper anterior neurovascular structures need to be displaced to provide access. Although various techniques have been described, the anterolateral approach is one of the safest and most effective methods available to access the anterior C2-C3 disc space. Despite the approach's efficacy, however, it can cause postoperative complications because of, at least partly, the inter-surgeon differences in the methods by which the larynx and hypopharynx are displaced medially.
  
  
  RESULTS
  We present a case report of a patient treated with a modified anterolateral approach to C2-C3. The approach provided excellent visualization while protecting vital structures. The patient recovered without any postoperative dysphagia or other surgical complications.
  
  
  CONCLUSIONS
  The anterolateral approach to C2-C3 described herein safely protects the contents of the submandibular triangle while providing a wide exposure for direct access to the C2-C3 disc space.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Neurological Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Tharin
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Vasu
authors.initials: V
authors.lastname: Divi
authors.affiliation: Department of Neurological Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Prolo
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Davud B
authors.initials: DB
authors.lastname: Sirjani
mesh_terms: D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D017586:Diskectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000601:surgery*; D007430:Intraoperative Care / Q000379:methods; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods; D010781:Photography; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D013123:Spinal Fusion / Q000379:methods*; D013124:Spinal Injuries / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: anterior cervical discectomies and fusion; anterolateral approach; high cervical spine; hyoid bone; quadrilateral space