A New Method to Determine the Optimal Skin Incision for Anterior Cervical Surgery with CT Multiplanar Reformation...

An accurate determination of the optimal level of transverse skin incision is important. We describe a new technique to determine the level on the basis of computed tomography multiplanar reformations techniques, and conducted a randomized controlled trial to determine the accuracy of the new method. Eighty patients were enrolled and evenly divided into two groups. Patients in group A were marked by the traditional technique, whereas patients in group B were marked by the new method. Standard exposure procedures were performed. Intra-operative fluoroscopy confirmed if the intervertebral discs exposed were the intended ones. At the end of the study, intra-operative fluoroscopy confirmed that the intervertebral discs inserted with needles were not the intended ones in ten cases (25%) in group A. However, only three cases (7.5%) were wrongly located in group B. There was a significant difference between the two groups (P = 0.03). No severe complications were seen in either group. The current study provides a feasible method to identify the accurate level of transverse skin incision.