Relevant Surgical Anatomy of the Anterior Cervical Spine, the High Retropharyngeal and the Subaxial Regions



In the present chapter, the relevant anatomic structures of the anterior neck and the anterior cervical spine are discussed, related to the high retropharyngeal and the anterior subaxial approaches. The relevant muscles, fasciae, vessels, and nerves are shown together with some details on the special anatomy of the cervical discs and the cervical neural foramens.


  1. 1.
    Gray H. Gray’s anatomy. Philadelphia, PA: Churchill Livingstone; 1989.Google Scholar
  2. 2.
    Hong JT, Kim TH, Kim IS, Yang SH, Sung JH, Son BC, et al. The effect of patient age on the internal carotid artery location around the atlas. J Neurosurg Spine. 2010;12(6):613–8.CrossRefGoogle Scholar
  3. 3.
    Lang J. Clinical anatomy of the cervical spine. Stuttgart: George Thieme Verlag; 1993.Google Scholar
  4. 4.
    Pfeiffer J, Ridder GJ. A clinical classification system for aberrant internal carotid arteries. Laryngoscope. 2008;118(11):1931–6.CrossRefGoogle Scholar
  5. 5.
    Murakami S, Mizutani J, Fukuoka M, Kato K, Sekiya I, Okamoto H, et al. Relationship between screw trajectory of C1 lateral mass screw and internal carotid artery. Spine. 2008;33(24):2581–5.CrossRefGoogle Scholar
  6. 6.
    Luzsa G. X-ray anatomy of the vascular system. Philadelphia: Lippincott; 1974.Google Scholar
  7. 7.
    Batra APS, Mahajan A, Gupta K. Marginal mandibular branch of the facial nerve: an anatomical study. Indian J Plast Surg. 2009;43(1):60–4.CrossRefGoogle Scholar
  8. 8.
    Stöhr M. Iatrogene Nervenläsionen. Stuttgart: George Thieme Verlag; 1996.Google Scholar
  9. 9.
    Cramer GD, Darby SA. Clinical anatomy of the spine, spinal cord, and ANS. Philadelphia: Elsevier Health Sciences; 2013.Google Scholar
  10. 10.
    Toniato A, Mazzarotto R, Piotto A, Bernante P, Pagetta C, Pelizzo MR. Identification of the nonrecurrent laryngeal nerve during thyroid surgery: 20-year experience. World J Surg. 2004;28(7):659–61.CrossRefGoogle Scholar
  11. 11.
    Nagayama I, Okabe Y, Katoh H, Furukawa M. Importance of pre-operative recognition of the nonrecurrent laryngeal nerve. J Laryngol Otol. 1994;108(5):417–9.CrossRefGoogle Scholar
  12. 12.
    Tateda M, Hasegawa J, Sagai S, Nakanome A, Katagiri K, Ishida E, et al. Nonrecurrent inferior laryngeal nerve without vascular anomaly as a genuine entity. Tohoku J Exp Med. 2008;216(2):133–7.CrossRefGoogle Scholar
  13. 13.
    Zhou J, Espinoza Orías AA, Kang X, He J, Zhang Z, Inoue N, et al. CT-based morphometric analysis of the occipital condyle: focus on occipital condyle screw insertion. J Neurosurg Spine. 2016;25(5):572–9.CrossRefGoogle Scholar
  14. 14.
    Russo VM, Graziano F, Russo A, Albanese E, Ulm AJ. High anterior cervical approach to the clivus and foramen magnum: a microsurgical anatomy study. Neurosurgery. 2011;69(1 Suppl Operative):ons103–14. discussions 115–6PubMedGoogle Scholar
  15. 15.
    Giles LGF. The clinical anatomy and management of cervical spine pain. London: Butterworth-Heinemann Medical; 2000.Google Scholar
  16. 16.
    Mercer S, Bogduk N. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine. 1999;24(7):619–26. discussion 627–8CrossRefGoogle Scholar
  17. 17.
    Tanaka N, Fujimoto Y, An HS, Ikuta Y, Yasuda M. The anatomic relation among the nerve roots, intervertebral foramina, and intervertebral discs of the cervical spine. Spine. 2000;25(3):286–91.CrossRefGoogle Scholar
  18. 18.
    Ebraheim N, Rollins JR, Xu R, Jackson WT. Anatomic consideration of C2 pedicle screw placement. Spine. 1996;21(6):691–5.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryKlikikum EsslingenEsslingen a.N.Germany
  2. 2.Department of Orthopaedic SurgeryMusculoskeletal Oncology Unit, Hospital Clinic Universitari de Barcelona, School of MedicineBarcelonaSpain

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