ABSTRACT
Safe exposure of the anterior portion of the spine allows the orthopedic surgeon to resect, manipulate, or instrument the spine to treat various abnormalities. The pediatric surgeon moves important structures out of the way to provide adequate and safe exposure for the orthopedic surgeons. The orthopedic indications for procedures requiring anterior spinal exposure are varied ranging from deformities (scoliosis and kyphosis), to mass resections, to traumatic injuries. Several maneuvers provide exposure of the anterior surface of the mid to lower cervical vertebrae. A transperitoneal approach provides the best exposure for the lumbosacral junction. Postoperative care differs depending on the location of the exposure and is shared with the orthopedic surgeon. Intraoperative complications vary depending on the level of the exposure. Paraplegia is a concern, especially when the exposure requires the division of multiple segmental arteries to the spine. The majority of postoperative complications are related to the respiratory system.
