ARTIFICIAL PEDICLE SCREW RECONSTRUCTION OF THE CERVICAL SPINE AFTER LATERAL PARAMEDIAN TRANSPEDICULAR APPROACH FOR LESIONS OF THE VENTRAL CERVICAL SPINAL CANAL

OBJECTIVE: We describe in detail the anatomic and surgical principles of a lateral cervical paramedian transpedicular approach, a novel technique that provides access to the ventral cervical spinal canal. We also describe single-stage posterior column reconstruction of the cervical spine in which traditional cervical lateral mass screws are used simultaneously to reconstruct the cervical pedicle and to allow for three-column stabilization in a continuous posterior screw-rod construct after this approach. METHODS: This technique is a modification of traditional thoracic posterolateral extracavitary approaches and has been used by our group for the resection of intradural and extradural spinal lesions, as we illustrate. RESULTS: This approach is particularly useful in cases where significant pathological characteristics of the trachea or esophagus preclude an anterior approach to the cervical spine and in cases in which multiple levels are involved. CONCLUSION: Cervical spinal stability is enhanced, because all cervical levels are incorporated into the final screw-rod construct.