Abstract
1. Position the patient supine. Slightly hyperextend the neck. rotated away from the side of the approach. Use the inflatable cervical pillow for support; a small roll under the shoulder often helps to extend the neck. Location of the thoracic duct and recurrent laryngeal nerve becomes even more important at this level. Approaches from the left for C6 through T2 are directly in the vicinity of the thoracic duct. Identify the thoracic duct when possible and protect it. A large fatty meal the day before surgery will help. If the thoracic duct is inadvertently divided, double ligate both ends well. The approach to the right should definitely identify the recurrent laryngeal nerve and protect it. We recommend the right supraclavicular approach with identification of the recurrent laryngeal nerve.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Henry AJ: Extensive Exposure. Baltimore, Williams & Wilkins, 1959, pp 53–72.
Robinson RA: Approaches to die cervical spine C1-T1. Chapter 22 in Schmidek HH, Sweet WH (eds): Current Techniques in Operative Neurosurgery. New York, Grune & Stratton, 1978, pp 205–302.
Riley L: Surgical approaches to the anterior structures of the cenical spine. Clin Orthop 91 (16):10–20, 1973.
Nanson EM: The antcrior approach to uppcr dorsal sympathectomy. Surg Gynccol Obstet 104:118–120, 1957.
Goss CM (ed): Gray’s Anatomy of the Human Body, 29th edn. Philadelphia, Lea & Febiger, 1973.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2003 Springer Science+Business Media New York
About this chapter
Cite this chapter
Watkins, R.G. (2003). Supraclavicular Approach. In: Surgical Approaches to the Spine. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-0009-0_10
Download citation
DOI: https://doi.org/10.1007/978-1-4613-0009-0_10
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-6508-5
Online ISBN: 978-1-4613-0009-0
eBook Packages: Springer Book Archive