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Surgical Anatomy of Upper Cervical Spine

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Anatomy Atlas and Interpretation of Spine Surgery

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Abstract

First reported by Kanavel in 1917, the transoral–transpharyngeal approach is the most direct surgical approach to the anterior occipitocervical area. This approach can preferably expose the anterior atlantoaxial structure and is often used for the resection of the anterior arch of the atlas and treatment of odontoid process base invagination, infection, tumor, and irreducible odontoid fractures during chronic dislocation. It is also used in the management of congenital malformation in the anterior atlantoaxial region. Since this surgical approach is limited by the mandible and oral cavity, its field of vision is relatively narrow. Its exposure generally ranges from the basilar clivus to the upper part of C3, but can be expanded toward the head by incising the soft and hard palates. The range of mandibular joint motion should be evaluated prior to surgery by physical examination and X-ray. For patients who have difficulty in opening their mouths, other surgical approaches should be considered. The advantage of the anterior approach is the absence of major vessels and nerves, and the most common complications are infection and cerebrospinal fluid leakage.

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Authors and Affiliations

  1. Department of Orthopedics, Changzheng Hospital, Shanghai, China

    Jian-gang Shi, Wen Yuan & Jing-chuan Sun

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  1. Jian-gang Shi
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  2. Wen Yuan
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  3. Jing-chuan Sun
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Correspondence to Jian-gang Shi .

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Editors and Affiliations

  1. Second Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China

    Jian-gang Shi

  2. Changzheng Hospital, Second Military Medical University, Shanghai, China

    Wen Yuan

  3. Second Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China

    Jing-chuan Sun

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Shi, Jg., Yuan, W., Sun, Jc. (2018). Surgical Anatomy of Upper Cervical Spine. In: Shi, Jg., Yuan, W., Sun, Jc. (eds) Anatomy Atlas and Interpretation of Spine Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-10-5906-3_1

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  • DOI: https://doi.org/10.1007/978-981-10-5906-3_1

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  • Online ISBN: 978-981-10-5906-3

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