Introduction: Management of lesions affecting the high cervical region i.e. the first to third cervical spine poses a significant challenge to spine surgeons due to the presence of critical Neuro-vascular structures.high cervical anterior retro pharyngeal approach is a useful technique In the armamentarium of spinal surgeons,as it helps in the management of a wide range of afflictions affecting this region.
Methods: We share our experience of 4 patients operated via high cervical anterior reteropharyngeal approach for various pathology like congenital, degenerative , infective , and traumatic . A observation study .
Results: A 16 year old girl with accidental strangulation of the neck while working on a machine had traumatic C2 C3 Listhesis with quadriparesis. She underwent anterior C2C3 discectomy and fusion. The second patient was an operated case of cervical myelopathy with spastic quadriparesis,with an ossified posterior longitudinal ligament with a short neck .He had previously undergone posterior decompression without any improvement. Despite his short neck, anterior C3 corpectomy and C2 to C4 fusion could be achieved. The third patient was a case of craniovertebral junction tuberculosis who had a failed posterior decompression and C1C 2 fusion. Only anterior debridement could be done without fusion as the C2 was also diseased. The patient showed clinical improvement after decompression and anti tubercular medication. The next patient described had severe spastic quadriparesis and fixed contracture at the knee joint. She had a congenitally malformed C3 vertebrae and kyphosis. C3 corpectomy with C2 to C4 fusion was performed without any complication.
Conclusion : The high cervical anterior reteropharyngeal approach is an important armamentarium for spinal surgeries, as it provides a wide and easier approach to the upper cervical spine. It also avoids the oral cavity and therefore decreases morbidity.
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