Fusion and instrumentation at C1-3 via the high anterior cervical approach

John R Vender, Steven J. Harrison, Dennis E. McDonnell

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Object. The high anterior cervical, retropharyngeal approach to the anterior foramen magnum and upper cervical spine is a favorable alternative to the transoral and posterolateral approaches, which both cause instability of the craniovertebral junction. Previously, such instability was corrected via an occipitocervical fusion during a separate surgical procedure. Methods. Seven patients requiring C-2 corpectomy (foramen magnum meningioma [two patients], critical stenosis secondary to rheumatoid arthritis [two patients], C-2 fracture [two patients], and stenosis secondly to Rickets [one patient]) are presented. All patients underwent C1-3 fusion followed by instrumentation with a Caspar plate. A solid fusion was achieved in six patients. One patient experienced erosion of the anterior arch of C-1 requiring posterior stabilization. Conclusions. Fusion and instrumentation at C1-3 can be performed safely and with minimal increase in surgical time. In selected patients, this may eliminate the need for an additional posterior procedure and maintain occipital-C1 mobility.

Original languageEnglish (US)
Pages (from-to)24-29
Number of pages6
JournalJournal of Neurosurgery
Issue number1 SUPPL.
StatePublished - Jan 1 2000


  • Anterior C1-3 arthrodesis
  • Caspar plate
  • Craniovertebral junction
  • Foramen magnum
  • Transcervical approach

ASJC Scopus subject areas

  • Clinical Neurology
  • General Neuroscience


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