For a study, the researchers sought to execute surgically relevant anterior cervical spine exposures, paying special emphasis to the RLN’s possible weaknesses on the right and left sides. The RLN’s vulnerability in the anterior cervical spine approach on the right versus left was a point of contention. Despite the fact that most cadaveric investigations focused on RLN course variations and structural relationships, they were conducted in preserved (fixed) cadavers with little regard for the needs of spinal exposure. About 12 fresh undyed cadavers were dissected layer by layer by two surgeons (one with extensive experience as an anatomy dissector). During cervical spinal surgeries, both sides were looked at for possible vulnerabilities. Each dissection was done in stages and went beyond what could be done in live surgery to provide the reader a greater understanding of the structures. The researchers consistently proved in all specimens that the proper surgical corridor entailed manipulation of the nerve and its branches, particularly below C5, to enable best midline access: the RLN was on its oblique route to the tracheoesophageal groove in the right corridor. RLN was already in the tracheoesophageal groove and out of the surgical field on the left, requiring only limited direct nerve mobilization. The RLN surgical anatomy shown was unique in that it used fresh, unprocessed cadaveric material, which had never been done before. The right surgical corridor, below C5, necessitates retraction/manipulation of the RLN in order to get optimal spinal midline access, underlining the right RLN’s surgical fragility.
Link:journals.lww.com/spinejournal/Abstract/2020/01010/Right__Versus_Left_sided_Exposures_of_the.4.aspx
