Superficial landmarks include:

•  hyoid C3

•  thyroid cartilage C4–5

•  cricoid C6

•  A horizontal incision is made just medial to the sternocleidomastoid muscle (SCM).

•  A decision on a right- or left-side approach should be made based upon surgeon comfort.

•  The platysma is divided in line with the skin incision.

•  The external jugular vein helps to identify the tracheoesophageal groove.

•  The SCM and carotid sheath are retracted laterally.

–   The tracheoesophageal complex is retracted medially.

–   The recurrent laryngeal nerve lies in the tracheoesophageal groove.

–   The cartoid sheath contains:

the internal jugular vein

the cartoid artery

the vagus nerve

•  The longus colli are swept laterally, exposing the superficial disk space.

–   The sympathetic chain lies superficial to the longus colli; therefore, retractors should be placed deep into this muscle.

•  A knife or electrocautery device can be used to perform the annulotomy.

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Cervical Surgical Positioning Posterior Cervical Laminectomy and Fusion Percutaneous Cement Augmentation Posterior Cervical Laminaplasty with Instrumentation Anterior Lumbar Interbody Fusion Percutaneous Pedicle Screw Placement

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