Skull clamp application: A safe, team-based approach and literature review

Charles Land, Blake Bowden, Lamar Callaway, Andrew Henderson, John Devine

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Outcomes in posterior cervical spine surgery are highly dependent on proper operative head and neck positioning. As with any spinal procedure, posterior cervical surgery can be associated with significant morbidity; known complications directly related to positioning include postoperative vision loss, neurological injury, and poor surgical outcome. Unsurprisingly, a variety of techniques have been developed that aim to mitigate these complications while improving overall outcomes. The aim of this article is to present a standardized technique for application of the Mayfield skull clamp focusing on a team-based approach for patient positioning to minimize complications. The existing literature is also reviewed for complications associated with head positioning devices. Our method of clamp application and patient positioning minimizes complications (0.36% over a 14-y period), optimizes surgical exposure with anatomic position of the bony elements, and maximizes intraoperative spinal stability. This protocol is ideal for all the posterior cervical procedures.

Original languageEnglish (US)
Pages (from-to)57-63
Number of pages7
JournalTechniques in Orthopaedics
Issue number1
StatePublished - Mar 2021


  • Cervical spine
  • Complications
  • Patient positioning
  • Posterior spine surgery
  • Skull clamp
  • Skull clamp application
  • Spinal decompression
  • Spinal fusion
  • Spine surgery
  • Team-based

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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