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Anterior Vertebral Artery Mobilization

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Abstract

Indication for mobilization of the VA depends on pathologies: simple displacement of the VA to approach a lesion or access of the VA enabling a vascular procedure.

The normal anatomy and its variation as abnormal way secondary to lesion must be known before surgery, helped by classical and angio-images.

Mobilization of the C2–C0 portion of VA is described in this chapter: the approach is retro-vascular, going between the jugular vein frontwards and the deep part of the sternocleidomastoid muscle backwards. (The spinal accessory nerve must be identified.)

Transverse processes of C1 and C2 are palpated and dissected subperiosteally, and the bone is slowly resected allowing to expose the VA and its mobilization.

If necessary the VA can be followed cranially and caudally.

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References

  1. Georges 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.

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  2. Bancel P. Abord antérieur de l’artère vertébrale et de la charnière occipito-cervicale. Société Française de Chirurgie Rachidienne. Paris: Laboratoire d’anatomie-Fer à Moulin; 2014.

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  3. Georges B, Laurian C. Surgical possibilities of the third portion of the vertebral artery above C2. Acta Neurochir. 1979;28:263–9.

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Correspondence to Philippe Bancel .

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© 2019 Springer Nature Switzerland AG

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Bancel, P. (2019). Anterior Vertebral Artery Mobilization. In: Koller, H., Robinson, Y. (eds) Cervical Spine Surgery: Standard and Advanced Techniques. Springer, Cham. https://doi.org/10.1007/978-3-319-93432-7_30

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  • DOI: https://doi.org/10.1007/978-3-319-93432-7_30

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93431-0

  • Online ISBN: 978-3-319-93432-7

  • eBook Packages: MedicineMedicine (R0)

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