The Smith-Robinson Approach to the Subaxial Cervical Spine: A Stepwise Microsurgical Technique Using Volumetric Models From Anatomic Dissections.

6533b823fe1ef96bd127f832

RESEARCH PRODUCT

The Smith-Robinson Approach to the Subaxial Cervical Spine: A Stepwise Microsurgical Technique Using Volumetric Models From Anatomic Dissections.

Vera Vigo Pau Capilla-guasch Vicent Quilis-quesada Vicent Quilis-quesada Juan C. Fernandez-miranda Pasquale De Bonis José M. González-darder Ayoze Doniz-gonzalez Felix Pastor-escartin Felix Pastor-escartin

subject

Anterior cervical approach Anterior cervical approach Anterior neck Cervical spine Smith-Robinson approach Surgical anatomy Volumetric models medicine.medical_treatment Surgical planning NO Smith-Robinson approach 03 medical and health sciences 0302 clinical medicine Surgical anatomy Volumetric models Cervical spine Platysma muscle medicine Humans 030212 general & internal medicine Anterior neck Anterior neck business.industry Dissection Surgical anatomy Anatomy Microsurgery Neurovascular bundle Cervical spine Dissection Cervical Vertebrae Neck Dissection Surgery Neurology (clinical)business 030217 neurology & neurosurgery Neck Diskectomy

description

BACKGROUND: The Smith-Robinson1 approach (SRA) is the most widely used route to access the anterior cervical spine. Although several authors have described this approach, there is a lack of the stepwise anatomic description of this operative technique. With the advent of new technologies in neuroanatomy education, such as volumetric models (VMs), the understanding of the spatial relation of the different neurovascular structures can be simplified. OBJECTIVE: To describe the anatomy of the SRA through the creation of VMs of anatomic dissections. METHODS: A total of 4 postmortem heads and a cervical replica were used to perform and record the SRA approach to the C4-C5 level. The most relevant steps and anatomy of the SRA were recorded using photogrammetry to construct VM. RESULTS: The SRA was divided into 6 major steps: positioning, incision of the skin, platysma, and muscle dissection with and without submandibular gland eversion and after microdiscectomy with cage positioning. Anatomic model of the cervical spine and anterior neck multilayer dissection was also integrated to improve the spatial relation of the different structures. CONCLUSION: In this study, we review the different steps of the classic SRA and its variations to different cervical levels. The VMs presented allow clear visualization of the 360-degree anatomy of this approach. This new way of representing surgical anatomy can be valuable resources for education and surgical planning.

year	journal	country	edition	language
2020-05-27	Operative neurosurgery (Hagerstown, Md.)

10.1093/ons/opaa265 https://pubmed.ncbi.nlm.nih.gov/32864701