Document Detail

Topographical anatomy of the anterior cervical approach for c2-3 level.
MedLine Citation:
PMID:  23420034     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To develop a clinically relevant anterior cervical approach (ACA) to the C2-3 level.
METHODS: Frequently encountered nerves [hypoglossal (HyN), internal (ISLN) and external superior laryngeal nerves (ESLN)] and vessels [lingual (LiA), superior laryngeal (SLA) and superior thyroid arteries (STA)] in the field of high ACA and the anatomic spatial markers [submandibular gland (SMG); sling for digastrics muscle (SDG); hyoid bone (HyB), and thyroid cartilage (ThC)] were evaluated using 18 fresh cadavers. The vertical distance of each structure at the carotid sheath and larynx and each disc for cervical level were measured from the suprasternal notch.
RESULTS: The cervical levels of SDG, SMG and HyB were mostly C3 and that of ThC was C5. The vertical locations of HyN and LiA were not significantly different and the levels corresponded to C2. The levels for ISLN and ESLN were C3 at carotid and C4 and C5 at larynx sides, respectively. The vertical locations of ISLN and HyN were significantly different at carotid (p = 0.001) and larynx (p < 0.001) sides. The vertical locations and cervical levels of SLA and STA at carotid and larynx sides were not significantly different with those of ISLN and ESLN, respectively. The HyN traversed C2 with accompanying LiA. The ISLN passed C3 and C4 from carotid to larynx sides and accompanied SLA.
CONCLUSIONS: The C2-3 level can be exposed through the space between the HyN and the ISLN by retracting the LiA superiorly, the SLA inferiorly, the HyB medially, and the carotid sheath laterally.
Soo-An Park; Je-Hun Lee; Yong-Seok Nam; Xiaochun An; Seung-Ho Han; Kee-Yong Ha
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Publication Detail:
Type:  Journal Article     Date:  2013-02-19
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  22     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-02     Completed Date:  2014-03-03     Revised Date:  2014-07-01    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1497-503     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Cervical Vertebrae / anatomy & histology*,  surgery*
Hyoid Bone / anatomy & histology
Laryngeal Nerves / anatomy & histology
Larynx / anatomy & histology
Middle Aged
Neck / anatomy & histology
Orthopedic Procedures / methods*
Thyroid Gland / anatomy & histology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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