Anterior Subaxial Approach



The anterior approach to the subaxial spine represents the standard approach to anterior pathologies in this region. Spreading soft tissues apart along preformed fascial compartments medial to the sternocleidomastoid muscle allows an atraumatic exposure of the ventral aspect of the spine from C2 to Th1. This approach is well tolerated and associated with low complication rates. The commonest complaints with delayed recovery are injuries to the recurrent laryngeal nerve and swallowing dysfunctions. Modifications of this approach allow direct anterior access to the neuroforamen or exposure of the vertebral artery for pathologies with extraspinal extension along nerve roots.


  1. 1.
    Chang U, Lee MC, Kim DH. Anterior approach to the midcervical spine. In: Kim DH, Henn JS, Vaccaro AR, Dickman CA, editors. Surgical anatomy and techniques to the spine. Philadelphia: Saunders Elsevier; 2006. p. 45–56.Google Scholar
  2. 2.
    Verbiest H. A lateral approach to the cervical spine: technique and indications. J Neurosurg. 1968;28:191–203.CrossRefGoogle Scholar
  3. 3.
    George B, Laurian C. Surgical approach to the whole length of the vertebral artery with special reference to the third portion. Acta Neurochir. 1980;51:259–72.CrossRefGoogle Scholar
  4. 4.
    Cole T, Veeravagu A, Zhang M, Ratliff JK. Surgeon procedure volume and complication rates in anterior cervical discectomy and fusions: analysis of a national longitudinal database. Clin Spine Surg. 2017;30(5):E633–9.CrossRefGoogle Scholar
  5. 5.
    Gabel BC, Lam A, Chapman JR, Oskouian RJ Jr, Nassr A, Currier BL, Sebastian AS, Arnold PM, Hamilton SR, Fehlings MG, Mroz TE, Riew KD. Perioperative vision loss in cervical spinal surgery. Global Spine J. 2017;7(Suppl 1):91S–5S.CrossRefGoogle Scholar
  6. 6.
    Patil CG, Lad EM, Lad SP, Ho C, Boakye M. Visual loss after spine surgery: a population-based study. Spine (Phila Pa 1976). 2008;33(13):1491–6.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryChristliches KrankenhausQuakenbrückGermany

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