====== Anterior approaches to the cervical spine ======

anterior [[odontoid screw]] 

2. C1–3 (upper cervical spine):

a) [[transoral approach]]: including [[odontoidectomy]] 

b) extrapharyngeal approaches: use [[nasotracheal intubation]] (so that the mandible can be com-
pletely closed) through the contralateral nares. The head is slightly extended and is rotated 15° to the contralateral side. 

Avoid any oral tubes

● medial extrapharyngeal approach: medial to carotid sheath. Provides a more anterior position than the lateral [[retropharyngeal approach]]. Structures encountered: branches of external carotid artery, upper laryngeal nerves, [[hypoglossal nerve]]

● lateral retropharyngeal approach: only the spinal accessory nerve is encountered

3. C3-C7: standard anterior cervical discectomy approach

a) For 1 or 2 level ACD For 1 level corpectomy, a horizontal incision is usually employed 

b) For more levels, a vertically oriented incision may be preferred to facilitate access