Posterior median access to the subaxial spine

Abstract

Although associated with a higher approach-related traumatic impact on the soft tissue of the neck than the anterior approach, the posterior median approach to the subaxial cervical spine remains standard for numerous indications. Reported procedure-related complications in posterior cervical surgical interventions can be significantly reduced by appropriate preoperative planning and patient positioning as also by a straightforward surgical approach technique and wound closure. Inadvertence during dissection leads to higher blood loss and extended surgical time; has a collateral impact on clinical outcomes, infection and revision rates; and might lead to adjacent segment degeneration and instability. Thus, the aim of the article is to present technical nuances and tips for complication avoidance related to the posterior median access to the subaxial spine.