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Simplified four-step retropharyngeal approach for the upper cervical spine: technical note
Pasquale De Bonis1, Antonio Musio2, Giorgio Mantovani1
1Department of Neurosurgery, Sant'Anna University Hospital, Viale Aldo Moro 8, 44124, Ferrara, Italy.
Summary
This study introduces a simplified four-step retropharyngeal approach for accessing the upper cervical spine. The technique is safe, effective, and rapid, minimizing complications for spinal surgeries.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Anatomy
Background:
- The classical retropharyngeal approach for upper cervical spine access involves numerous steps.
- Minimizing surgical invasiveness and complications is crucial for patient outcomes.
Purpose of the Study:
- To present a simplified, four-step retropharyngeal surgical approach.
- To reduce operative time and potential complications when accessing the upper cervical spine.
Main Methods:
- A novel four-step technique involving patient positioning, skin-platysma incision, hyoid bone dissection, and retropharyngeal blunt exposure.
- Avoidance of dissection of specific anatomical structures like the submandibular gland, facial veins, and cranial nerves.
Main Results:
- The simplified approach was successfully applied to five patients with conditions including C2-C3 herniated disc, Hangman fracture, and C2-C3 osteophyte.
- Rapid intraoperative times for retropharyngeal space exposure were achieved, ranging from 7 to 15 minutes.
- No intraoperative complications were reported in any of the cases.
Conclusions:
- The simplified four-step retropharyngeal approach is a safe, effective, and rapid method for upper cervical spine surgery.
- This technique offers a reduced learning curve compared to the classical approach.
