Introduction: Anterior approaches to the cervical spine are routinely performed by neurosurgeons and orthopedic surgeons to gain access to the cervical disc and vertebral bodies. Currently, there is a paucity of literature describing the microanatomical fascial planes of the neck with respect to anterior cervical approaches; thus, we delineate relevant cervical fascial planes pertinent to the anterior cervical exposure for ease of access.
Methods: We demonstrate a stepwise method of identifying the correct planes for anterior cervical exposure using a cadaveric model, illustrations, the Visible Human Project®, and an original surgical video.
Results: A reproducible step-by-step method of identification of the anterior cervical fascial planes is demonstrated, including the superficial layer of the deep cervical fascia, infrahyoid fascia, ventral pretracheal fascia, alar fascia, and the prevertebral fascia. We show the critical structures that reside within these fascial planes, such as the superior and inferior thyroid artery, as well as the superior laryngeal nerve.
Conclusion : Anterior cervical spine exposure requires a thorough understanding the fascial planes of the neck, and the neurovascular structures that reside within. This allows a methodical and efficient surgical approach to the prevertebral space that minimizes retraction and iatrogenic injury.
