[Ventral approaches to the upper cervical spine].

The transoral approach to the upper cervical spine and the respective neuraxis has been recognized for almost 100 years, but it is still not in common use. Based on over 200 operations on patients with a variety of lesions and an age range from 2 1/2 to 83 years, we outline the pathological mechanism, surgical anatomy, indications for surgery, preoperative investigations, variations and extensions of the transoral approach to the upper cervical spine, neuraxis and skull base. The most common post-traumatic lesions and the most frequent tumors are discussed and the recommended surgical approach is described. Surgical techniques, possible complications and their management, as well as postoperative care, are listed.