Cervical Surgical Positioning
■ Anterior Cervical – Cervical Surgical Positioning
• The head is placed onto a doughnut to maintain its position.
A bump or roll is placed horizontally across the scapulae to allow for gentle extension of the cervical spine.
Care should be taken to avoid hyperextension in patients with spinal cord compression and myelopathy.
Tape is applied to the top of the shoulders to depress them gently for improved visualization of the lower cervical segments.
A foam pad is placed over the elbows to protect the ulnar nerve.
■ Posterior Cervical
• The Mayfi eld is placed with the pins along the mastoid process and posterior to the temporal artery and masseter muscle.
The pins are typically tightened to 60–80 psi.
• The table is slightly raised with the head above the feet to allow for venous drainage.
• The patient is then placed into a prone position with chest rolls and the Mayfield locked into the operative position.
Flexion of the neck allows for opening of the spinal canal and easier decompression.
A more neutral alignment should be performed prior to placement of the final instrumentation.
The arms are gently taped with a gentle depression of the shoulders to allow for increased visualization of the lower cervical segments.