Transoral cervical corpectomy with the aid of the microscope

The transoral transpharyngeal approach to the upper cervical spine is useful in symptomatic cases of chronic atlantoaxial dislocation not reducible by other means. Spontaneous healing and fusion in such patients results in an anterior deformity or gibbus which indents the ventral surface of the spinal cord. This lesion is best approached anteriorly, with the neck in a neutral or extended position. Previously reported complications of the transoral operation, especially vertebral artery laceration, can be avoided through used of the microscope. The technique is described and 2 cases are presented. Spinal stability was not disrupted in either, and cord decompression was accomplished.