An anatomical study of the different neurosurgical approaches of the cervical spinal cord

Fouad, Wael; Elzawawy, Ehab Mostafa

doi:10.1016/j.ajme.2011.03.001

Cited by 4 publications

(7 citation statements)

References 24 publications

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“…During the dissection of longus colli muscle, care should be taken to prevent injury to the cervical sympathetic chain and ventral part of the vertebral artery, as these structures lie posterior to the muscles [1,11].…”

Section: Discussionmentioning

confidence: 99%

“…However, this injury is infrequent in upper cervical approaches because the surgical plane is above the thyroid cartilage. The recurrent laryngeal nerve is most commonly injured in low cervical approaches [1,6].…”

Section: Discussionmentioning

confidence: 99%

“…However, the upper cervical spine (C1-C4) poses unique anatomic and technical challenges [1][2][3]. In this anatomic study, we present a step by step cadaveric dissection of the high anterior cervical spine approach to elucidate anatomical considerations and key anatomical variants which may be encountered.…”

Section: Introductionmentioning

confidence: 99%

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Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study

Fard

Patel

Avila

et al. 2015

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study

Fard

Patel

Avila

et al. 2015

Journal of Clinical Neuroscience

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“…[ 48 ] Additionally, recurrent laryngeal nerve injury is more frequent in the lower cervical approach than in upper approach, as in the latter, the surgical corridor is above the thyroid cartilage. [ 50 ]…”

Section: Discussionmentioning

confidence: 99%

Transcervical, retropharyngeal odontoidectomy – Anatomical considerations

Yakdan,

Greenberg,

Krishnaney

et al. 2023

Journal of Craniovertebral Junction and Spine

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Context: Anterior craniocervical junction lesions have always been a challenge for neurosurgeons. Presenting with lower cranial nerve dysfunction and symptoms of brainstem compression, decompression is often required. While posterior approaches offer indirect ventral brainstem decompression, direct decompression via odontoidectomy is necessary when they fail. The transoral and endoscopic endonasal approaches have been explored but come with their own limitations and risks. A novel retropharyngeal approach to the cervical spine has shown promising results with reduced complications. Aims: This study aims to explore the feasibility and potential advantages of the anterior retropharyngeal approach for accessing the odontoid process. Methods and Surgical Technique: To investigate the anatomical aspects of the anterior retropharyngeal approach, a paramedian skin incision was performed below the submandibular gland on two cadaveric specimens. The subcutaneous tissue followed by the platysma is dissected, and the superficial fascial layer is opened. The plane between the vascular sheath laterally and the pharyngeal structures medially is entered below the branching point of the facial vein and internal jugular vein. After reaching the prevertebral plane, further dissection cranially is done in a blunt fashion below the superior pharyngeal nerve and artery. Various anatomical aspects were highlighted during this approach. Results: The anterior, submandibular retropharyngeal approach to the cervical spine was performed successfully on two cadavers highlighting relevant anatomical structures, including the carotid artery and the glossopharyngeal, hypoglossal, and vagus nerves. This approach offered wide exposure, avoidance of oropharyngeal contamination, and potential benefit in repairing cerebrospinal fluid fistulas. Conclusions: For accessing the craniocervical junction, the anterior retropharyngeal approach is a viable technique that offers many advantages. However, when employing this approach, surgeons must have adequate anatomical knowledge and technical proficiency to ensure better outcomes. Further studies are needed to enhance our anatomical variations understanding and reduce intraoperative risks.

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“…The choice of approach in the cervical spine should be determined by the location of the primary pathology. [15] After tumor resection, the sample was examined histopathological, and the results showed tissue consists of large spindle cells with collagen fibers with small spindle cells arranged to form a palisade and no signs of malignancy, conclusion is a neurofibroma.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes in Primary Benign Extradural Tumors of The Cervical Spine

Musfirah,

Iskandar,

Ananda

2023

AANHS-J

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Introduction: The prevalence of spinal tumors is rare, only about 15% of all cases of central nervous system tumors and 90% of cases occur at the age of >20 years, which is a productive age for a person. Case Report: A young 25-year-old woman came to the polyclinic complaining of weakness of both hands and feet (all limbs). The MRI results show a suspected of a space occupying lesion of the extradural spinal cord. The patient then underwent tumor removal laminectomy surgery with a posterior approach. After the operation, his motoric was improving and increased to 4/4. After three months she was able to walk and perform daily activities. Discussion: In younger patients, the tumor diagnosis may be more catastrophic, and the required treatment can have a severe impact on the patient's health-related quality of life. The patient was also very fast and assisted with early ambulation. This can be related to the progressivity of tumor cells, in this case a benign tumor with a border that is not aggressive in invading the surrounding tissue. Conclussion: Early diagnostic and complete surgical resection before the occurrence of severe symptoms will show an excellent prognosis in benign primary extradural tumor. Multidisciplinary surgical planning should therefore also include the histological grade, stage, and extent of the tumor to establish the objective biological aggressiveness of the overlying tumor and in turn estimate the feasibility of resection Keywords: Benign; Primary extradural tumor; Surgical outcome

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An anatomical study of the different neurosurgical approaches of the cervical spinal cord

Cited by 4 publications

References 24 publications

Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study

Anatomic considerations of the anterior upper cervical spine during decompression and instrumentation: a cadaveric based study

Transcervical, retropharyngeal odontoidectomy – Anatomical considerations

Surgical Outcomes in Primary Benign Extradural Tumors of The Cervical Spine

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