- Department of Neurosurgery, Centre Clinical de Soyaux, Soyuax, France,
- Department of Neurosurgery, Carl Thiem Klinikum, Cottbus, Germany.
Keyvan Mostofi, Department of Neurosurgery, Centre Clinical de Soyaux, Soyuax, France.
DOI:10.25259/SNI_996_2022Copyright: © 2022 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Keyvan Mostofi1, Morad Peyravi2. Modified anterior retropharyngeal approach for C2-C3 disc herniation. 02-Dec-2022;13:568
How to cite this URL: Keyvan Mostofi1, Morad Peyravi2. Modified anterior retropharyngeal approach for C2-C3 disc herniation. 02-Dec-2022;13:568. Available from: https://surgicalneurologyint.com/?post_type=surgicalint_articles&p=12033
Background: C2-C3 disc herniations are rare, but occur more frequent in the elderly population. As the classical anterior Cloward approach to these lesions is not optimal, we propose an alternative modified retropharyngeal approach to these disc herniations that were successfully utilized in two patients.
Methods: Two patients with C2-C3 disc herniations underwent anterior cervical surgery utilizing the modified retropharyngeal approach.
Results: Surgery was successful is two cases with C2-C3 disc herniation and no patient sustained a perioperative complication.
Conclusion: Our modified anterior retropharyngeal approach for C2-C3 disc herniations resulted in good outcomes without perioperative complications.
Keywords: Cervical disc herniation, Degenerative diseases, Spine surgery, Upper cervical instrumentation, Disc herniation
C2-C3 disc herniation is rare. We were able to identify <50 such cases have in the literature.[
Two patients, ages 68 and 59, presented with C2-C3 disc herniations. The first patient had a cervical MRI that sowed a left posterolateral C2-C3 disc herniation compressing the C3 nerve root. He underwent a modified retropharygeal anterior C2-C3 discectomy/fusion using an intersomatic porous alumina ceramic cervical cage with good resolution of his pain a few weeks after surgery. The second patients cervical MRI demonstrated a posterior/central C2-C3 disc herniation with bilateral foraminal stenosis and cord compression but without a high intramedullary cord signal. He too had a modified retropharyngeal C2-C3 discectomy employing an intersomatic porous alumina ceramic cervical cage, and returned to work 2 months after surgery [
Patient is in supine position with the neck in extension and head fixed on a Mayfield headrest and rotated 45° to contralateral side. This approach utilized an oblique anterior incision parallel to the mandible [
The anterior approach to a C2-C3 cervical disc herniation is difficult due to the complex regional anatomy; the presence of mandible, cranial nerves, critical veins, and arteries.[
Our modified anterior retropharyngeal approach for C2-C3 disc herniation is better tailored to the complex regional anatomy and would likely lower complication rates associated with anterior C2-C3 disc resections.
Patients’ consent not required as patients’ identities were not disclosed or compromised.
There are no conflicts of interest.
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Journal or its management. The information contained in this article should not be considered to be medical advice; patients should consult their own physicians for advice as to their specific medical needs.
We would like to thank Mrs. Estelle CARRE for these magnificent drawings which contribute to the better understanding of our paper.
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