Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Prevertebral Vascular and Esophageal Consideration during Percutaneous Cervical Disc Procedures Jae Kyun Jeon, M.D.1*, Chang Hyun Oh, MD 1*, Daeyeong Chung, MD 2, Junho Lee, MD 1, Seung Hyun Choi, MD 1, Gyu Yeul Ji, MD 3, Eunhwa Choi, MD 4 * These authors contributed equally to this project and should be considered as co- first authors 1 Department of Neurosurgery, Spine and Joint Research Institute, Guro Teun Teun Hospital, Seoul, Korea 2 Department of Neurosurgery, Daegu Teun Teun Hospital, Daegu, Korea 3 Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea 4 Department of Diagnostic radiology, Guro Teun Teun Hospital, Seoul, Korea

● The percutaneous anterior approach has been used for minimally invasive interventions of cervical disc diseases. ● Cervical magnetic resonance image (MRI) scans taken were evaluated in this study. Each axial MR image from the cervical disc levels was reviewed to check for the presence of small vessels along the trajectories of percutaneous cervical procedures on the left and right sides. Esophageal deviation was also measured at level C6/7. ● Significantly fewer vascular structures in the prevertebral areas of C5/6 and C6/7 were found on the right side, while esophageal deviation was predominant to the left side. Anatomical consideration of the prevertebral area may prevent vascular and esophageal injury.

Figure 1. Small vessels were less frequently observed on the right side at lower cervical levels (C5/6/7).

Figure 2. Differences in esophageal deviation were also observed, with less deviation to the right side (0.63 ± 0.35 cm) than the left (1.18 ± 0.52 cm).