Right Versus Left Approach to Anterior Cervical Discectomy and Fusion: An Anatomic Versus Historic Debate.

Abstract:

:The debate over the influence approach sidedness has on the risk of recurrent laryngeal nerve palsy (RLNP) following anterior cervical discectomy and fusion (ACDF) has its origins with the introduction of the procedure for radicular pain in the 1950s. The recurrent laryngeal nerves follow disparate courses in the lower neck secondary to differences in embryogenesis. Because of these differences, some authors believe a right-sided approach increases the risk of RLNP. However, modern surgical series have not shown a clear risk of RLNP with a right- versus left-sided approach. By looking at the historical context surrounding the introduction of ACDF, we propose the dogmatic view of an increased risk of RLNP with a right-sided approach likely arose from a combination of theoretical anatomic risk and the early surgical experience of a pioneer of the procedure.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Johnson MD,Matur AV,Asghar F,Nasser R,Cheng JS,Prestigiacomo CJ

doi

10.1016/j.wneu.2019.12.052

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

135-140

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)33081-5

journal_volume

135

pub_type

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