Department of Neurosurgery, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Acta Neurochir (Wien). 2024 Mar 6;166(1):122. doi: 10.1007/s00701-024-06012-2.
One of the major challenges in operating on the spine lies in taking an anterior approach for the high cervical spine. In patients with a short neck, Klippel-Fiel syndrome or when the C3 vertebra is high in relation to the hyoid bone, it will be difficult to access the C3 body. The transoral route is a highly contaminated zone, and therefore, no instrumentation or grafts can be placed through it.
The anterior retropharyngeal approach (ARPA) for the high cervical spine.
The anterior retropharyngeal approach is an excellent approach for the high cervical spine where instrumentation is needed. This route provides wide exposure of the C1-C3 region, avoiding the contaminated of the oral cavity.
在脊柱手术中,一个主要的挑战是对高位颈椎进行前路入路。对于短颈、克莱佩尔-费尔综合征或 C3 椎体相对于舌骨较高的患者,很难触及 C3 椎体。经口途径是一个高度污染的区域,因此,不能通过它放置器械或移植物。
高位颈椎前路咽后入路(ARPA)。
对于需要器械的高位颈椎,前路咽后入路是一种很好的方法。该入路可提供 C1-C3 区域的广泛显露,避免了口腔的污染。