Authors of section

Author

Anton Fürst

Executive Editor

Jörg Auer

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Ventral midline approach to the cervical spine

1. Skin incision

With the patient in dorsal recumbency, a 30 cm midline ventral skin incision is made centered on the affected vertebra, identified with the help of intra-operative radiographic guidance.

plate fixation with atlantoaxial arthrodesis

Staples are used to identify the precise localization of the cervical vertebrae of interest during surgery.

ventral midline approach to the cervical spine

2. Exposure

The cutaneous, sternohyoid, omohyoid, and sternothyroid muscles are separated longitudinally along the midline to expose the trachea.

ventral midline approach to the cervical spine

Once the trachea is identified, it is retracted to the left and blunt dissection is continued along the right side of the trachea, separating it from the carotid artery and vagosympathetic trunk.

ventral midline approach to the cervical spine

The longus colli muscles are now exposed. The carotid arteries and vagosympathetic trunks are identified, and to some extent protected, with a Penrose drain. Two self-retaining Inge retractors are placed to gain access to the longissimus colli muscles covering the ventral aspect of the spinal column.

ventral midline approach to the cervical spine

A periosteal elevator and Mayo scissors are used to divide the two bellies of the longus colli muscles and to separate the fibers from the ventral process of the vertebra.

ventral midline approach to the cervical spine

The ventral surface of the vertebral column is exposed.

ventral midline approach to the cervical spine