Table 1.

Overview of the anterior approaches to the cervical spine

Level of cervical spine	Type of anterior approach	Advantages	Disadvantages
C1–C2	Transoral	Provides access to largely inaccessible pathologies and anatomical zones Relatively direct approach Midline approach Shorter learning curve	Oral complications Infections Postoperative care and feeding Wound healing CSF oral fistula
C2–C7	Anterolateral cervical	Reliable and reproducible Follows anatomical plane of dissection Minimal chance of injury to vital structures	Esophageal and tracheal compression/injury Horner’s syndrome Strictly midline, difficult to deal with lateral pathologies
C7–T4	Transmanubrium	Provides anterior access to upper thoracic and lower cervical spine Avoids morbidity of sternal split	Window of surgery is limited Midline approach Vital structures injury Lung infections

CSF – Cerebrospinal fluid