This document discusses anterior cervical approaches for spinal surgery. It recommends using a table suitable for imaging access, neuro-monitoring, positioning the patient supine with cervical immobilization such as a pillow rest or frame, and slightly extending the cervical spine with a scapula bump.

1. ANTERIOR CERVICAL APPROACHES
• Operating room table suitable for easy imaging access
• Electrophysiologic neuro-monitoring
• Positioning supine
• Anesthesia general (awake fiberoptic intubation in cases of severe
myelopathy/ instability)
• Cervical immobilization pillow rest, Gardner-Wells tongs, Mayfield three
pin head frame, or Halo
• Slight cervical extension with scapula bump