By Robert G. Watkins M.D. (auth.)
ISBN-10: 1468401556
ISBN-13: 9781468401554
ISBN-10: 1468401572
ISBN-13: 9781468401578
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Extra resources for Surgical Approaches to the Spine
Sample text
Bailey RW, Bagley CD: Stabilization of the cervical spine by anterior fusion. Am J Bone Joint Surg 42:565, 1960. 2. Cloward R: Ruptured Cervical Intervertebral Discs. Codman Signature Series 4. Codman and Shurtleff, 1974. 3. Perry J: Surgical approaches to the spine. In Pierce D, Nichol V (eds): The Total Care of Spinal Cord Injuries. Boston, Little Brown, 1977, pp 53-79. 4. Riley L: Surgical approaches to the cervical spine. Clin Orthop 91: 16, 1973. 5. Robinson RA: The Craft of Surgery, 2nd edn.
Palpate the anterior surface of the vertebral body. Open the prevertebral fascia with a small dissector longitudinally until the disc can be seen. Blunt dissection and finger palpation will allow the esophagus to move easily with the medial musculovisceral column. Insert angle retractors to the full depth of the wound prior to vigorous medial retraction. Anterior Medial Approach to the Midcervical Spine 31 Fig. SG: Incise the prevertebral tissue in the midline on the disc and dissect with a sharp periosteal elevator in a lateral direction.
Do not cover the arm with a sterile stockinette, as the operative field can be satisfactorily prepped and draped using standard orthopaedic technique, excluding the portion of the upper extremity distal to the midbiceps (Fig. 11A). 2. Place the incision transversely at the base of the natural axillary hairline, and deepen it by electrocautery in the most direct manner to the chest wall. Divide the pectoralis musculature (Fig. lIB). Caution: It is important to avoid undermining the succulent axillary soft tissues by oblique dissection.