title: Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study.
abstract: We evaluated the anatomical considerations specific to the high anterior retropharyngeal approach to the cervical spine. Surgical exposure of the anterior upper cervical spine can sometimes be challenging due to the surrounding neurovascular structures. Using three adult cadavers, we performed high anterior retropharyngeal cervical dissection of the left and right side for a total of six approaches (six sides). During the dissection, all important neurovascular elements were noted and photographed, and anatomical relationships to the spinal vertebral bodies and disc spaces were analyzed. There are certain anatomic considerations that are unique to the high anterior cervical spine. The unique structures include the hypoglossal nerve and the superior thyroid artery/nerve. Only the superior thyroid artery in this region has numerous anatomical variations. Awareness of other structures, including the carotid artery, recurrent laryngeal nerve, and esophagus also remains important. Awareness of the anatomical structures in the anterior upper cervical spine is essential for performing safe anterior upper cervical spinal surgery, avoiding serious complications.
authors.affiliation: Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA.
authors.forename: Salman Abbasi
authors.initials: SA
authors.lastname: Fard
authors.affiliation: Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA.
authors.forename: Apar S
authors.initials: AS
authors.lastname: Patel
authors.affiliation: Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA.
authors.forename: Mauricio J
authors.initials: MJ
authors.lastname: Avila
authors.affiliation: Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA.
authors.forename: Kamran V
authors.initials: KV
authors.lastname: Sattarov
authors.affiliation: Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Walter
authors.affiliation: Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Skoch
authors.affiliation: Division of Neurosurgery, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724 USA. Electronic address: abaaj@surgery.arizona.edu.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Baaj
mesh_terms: D000328:Adult; D002102:Cadaver; D017536:Carotid Artery, Common / Q000601:surgery; D002574:Cervical Vertebrae / Q000033:anatomy & histology* / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D004210:Dissection; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D013961:Thyroid Gland / Q000098:blood supply*
keywords: Anatomy; Cadaveric study; Neck; Retropharyngeal approach; Upper cervical spine