Mandibular Splitting Approach to the Upper Anterior Vertebral Canal

  • E. S. Stauffer


Adequate exposure of mass lesions behind the vertebral bodies of the second and third cervical vertebrae may be difficult to achieve through the standard anterolateral approach, due to limitations at the superior margins of the exposure. Adequate exposure at the superior end of the anterolateral approach requires division of the superior thyroid and lingual and facial branches of the external carotid artery and places the superior laryngeal nerve in jeopardy. This nerve innervates the vocal cords and is responsible for shouting and singing high notes. The standard exposure through the open mouth transpharyngeal approach is frequently hampered due to the limited range of motion of the temporal mandibular joint and the depth of the wound as one approaches the posterior aspects of the vertebral bodies. It is also difficult to get caudad to the C2–C3 intervertebral disc. On occasion, particularly with patients who have been operated on previously, wider exposure is necessary to adequately remove mass lesions from the anterior vertebral canal which are producing progressive myelopathy.


Vertebral Body Cervical Vertebra Adequate Exposure Superior Laryngeal Nerve Direct Anterior Approach 
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Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • E. S. Stauffer
    • 1
  1. 1.SpringfieldUSA

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