Institute for Modern & Innovative Surgery, Fort Lauderdale, Florida, USA.
J Neurosurg Spine. 2012 Sep;17(3):194-8. doi: 10.3171/2012.5.SPINE111112. Epub 2012 Jul 6.
Multilevel anterior cervical fusion often necessitates a large extensile incision for exposure and substantial retraction of the esophagus for placing long plates, potentially predisposing patients to complications such as dysphagia, dysphonia, and neurovascular injury. To the authors' knowledge, the use of 2 incisions as an option has not been published, and so it is not intuitive to young surgeons or widely practiced. In this report, the authors discuss the advantages and raise awareness of using 2 incisions for multilevel anterior cervical fusion, and they document a safe skin bridge length. They also describe the advantages of using 2 incisions for performing multilevel anterior cervical fusion either at contiguous or noncontiguous levels as in adjacent-segment disease. By using the 2-incision technique, the authors made the surgery technically easier and diminished the amount of esophageal retraction otherwise needed through 1 long transverse or longitudinal incision. A skin bridge of 3 cm was safe.
多节段前路颈椎融合术通常需要大的广泛切口来暴露，需要长时间的食管牵拉来放置长钢板，这可能使患者容易出现吞咽困难、声音嘶哑和神经血管损伤等并发症。据作者所知，使用两个切口的方法尚未发表，因此对于年轻的外科医生或广泛实践来说并不直观。在本报告中，作者讨论了使用两个切口进行多节段前路颈椎融合术的优点，并提出了安全的皮桥长度。他们还描述了在相邻节段疾病的情况下，使用两个切口进行连续或非连续多节段前路颈椎融合术的优点。通过使用双切口技术，作者使手术在技术上更容易，并减少了通过 1 个长的横向或纵向切口所需的食管牵拉量。3 厘米的皮桥是安全的。
