Adult & Pediatric Spine

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Anatomic considerations for plate-screw fixation of the cervical spine. S548-551. 2. An HS, Glover JM. Lumbar spinal stenosis, historical perspectives, classification, and pathoanatomy. Sem Spine Surg 1994:6:69-77. 3. Bland IH, Boushey DR. Anatomy and physiology of the cervical spine. Semin Arthritis Rheum 1990;20:1-20. 4. Bogduk N. The innervation of the lumbar spine. Spine 1983;8:286-293, 5. Bogduk N, Tynan W, W ilson A. The nerve supply to the human intervertebral discs. J Anat 1981;132:39-56.

1 3 . Diagram of the combined low cervical and transthoracic approach to the cervicothoracic junction for severe kypho­ scoliosis. osteum. A t th is p o in t, th e ex p o se d in ferio r th y ro id vein and, if n ecessary , th e in n o m in a te v e in m ay be ligated. D isse ctio n is th e n co n tin u ed b e tw e e n th e le ft carotid artery on th e left, and th e in n o m in a te artery, trachea, and esop hagu s on th e righ t. S p e c ia l atten tio n m ust be given to p ro tectio n o f th e th o ra c ic d u ct and left recu rren t laryn g eal n erve.

If la m in e c to m y h as b e e n perfo rm ed , a la tera l fa cet w irin g, L uque rod d in g , or la tera l m ass p latin g ca n be perfo rm ed (1, 9, 18, 3 0 , 3 9, 5 9 , 66). Anterior Exposure to the Upper Cervical Spine A n terio r a p p ro a ch es to th e u p p er p art o f th e ce rv ica l sp in e in c lu d e d islo ca tio n o f th e tem p o ro m an d ib u lar jo in t (63), o steo to m y o f th e m a n d ib le (42), tran soral ap p ro a ch (24, 2 5, 2 6 , 34), an d an terio r retro p h a ry n ­ geal ap p ro ach es (28, 5 7 , 89).

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