auggieMemberOctober 24, 2012 at 11:04 amPost count: 1
If one’s symptoms are primarily on the LEFT side & due to spondylosis & spinal canal stenosis, would the incision be placed on the right anterior side of the neck, or does it matter? This surgery was attempted on my husband, but due to his large (size 22″)neck, and 3 previous thyroid surgeries, they were unable to get down to the spine & nerve roots safely, & the surgery was discontinued & closed. There is discussion now regarding a posterior fusion, but he has also had two previous posterior cervical diskectomies in the past. What are your thoughts about this?Donald Corenman, MD, DCModeratorOctober 24, 2012 at 6:23 pmPost count: 8460
The approach side for the neck does not matter regarding which side the pathology is on regarding the spine itself. There are general factors that decide which approach side the surgeon prefers.
One is the anatomy of the neck. There is a very small nerve called the recurrent laryngeal nerve. This nerve supplies the vocal cords and there is one on each side of the neck. On the left side, the nerve consistently does not cross the surgical field. On the right side, the nerve crosses the surgical approach dissection about 5% of the time.
Interestingly enough, spine surgeons choose the left sided approach almost all the time and neurosurgeons choose the right sided approach most of the time. You can almost be sure that a spine surgeon performed the surgery by the left sided scar on the neck.
Previous surgeries in the neck require some prior preparation. Scar can make the dissection more difficult. If there has been a significant prior neck surgery or prior radiation treatment (for cancer), I will have my Ear Nose Throat (ENT) colleague assist me with the surgical approach. Ask your surgeon if this is something he would consider. The ENT surgeon typically has experience with these type of revision neck surgeries and should be able to safely dissect out the scar and gain access to the anterior neck.
Posterior decompression and fusion can be effective but is typically less effective than an anterior surgery and takes much longer to heal.
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