Anterior retropharyngeal approach (ARPA) for high cervical spine

Acta Neurochirurgica (2024) 166:122

One of the major challenges in operating on the spine lies in taking an anterior approach for the high cervical spine. In patients with a short neck, Klippel-Fiel syndrome or when the C3 vertebra is high in relation to the hyoid bone, it will be difficult to access the C3 body. The transoral route is a highly contaminated zone, and therefore, no instrumentation or grafts can be placed through it.

Method The anterior retropharyngeal approach (ARPA) for the high cervical spine.

Conclusion The anterior retropharyngeal approach is an excellent approach for the high cervical spine where instrumentation is needed. This route provides wide exposure of the C1–C3 region, avoiding the contaminated of the oral cavity.