Sacrospinous hysteropexy (SSH) is increasingly being performed, yet limited evidence exists on whether an anterior versus posterior compartment surgical approach may affect postoperative prolapse symptoms or differences in adverse events. The objectives of this study were to evaluate whether an anterior versus posterior approach to SSH affects short-term postoperative bulge symptoms; secondarily, assess differences in intraoperative and 30-day postoperative complication rates. A retrospective cohort analysis of women who underwent anterior or posterior compartment approach native tissue transvaginal SSH between 2016 and 2024 at 2 academic institutions was performed. The primary outcome was the presence of bulge symptoms. Secondary outcomes were retreatment with pessary or surgery, operative data, and 30-day postoperative adverse events categorized by the Clavien-Dindo system. Study inclusion criteria were met by 316 women. Women in the anterior approach group were older (mean ± SD shown), (70 ± 7 vs 64 ± 15) years, P < 0.0001, had a higher Charlson Comorbidity Index (CCI), median (IQR) (3 [2-4] vs 0 [0-0], P <0.0001), proportion of stage 3 and 4 prolapse (95/162 [58.6%] vs 65/154 [42.2%], P = 0.004), and greater point Ba on Pelvic Organ Prolapse Quantification (POP-Q) examination (2 [1, 3] vs 0 [-1, 2], P < 0.0001), respectively. Controlling for age, preoperative POP-Q stage, preoperative dominant prolapse compartment, and concomitant midvaginal repairs, proportional hazards modeling showed bulge symptoms earlier in the posterior approach group ( P = 0.002). There was a higher proportion of Clavien-Dindo I and II 30-day complications in the anterior approach group (21.6% vs 7.1%, P = 0.0002). Undergoing an anterior approach to native tissue SSH may be protective to both bulge symptom recurrence and retreatment but was associated with higher short-term complications. Prospective longer-term outcomes are needed.

Postoperative function of lower extremity muscles and walking ability after total en bloc spondylectomy for lumbar spinal tumors.

Comparing early practice outcomes of the direct anterior approach in total hip arthroplasty vs alternative approaches in direct anterior fellowship trained surgeons.

Esophageal Injury Following Anterior Cervical Discectomy and Fusion: A Single-institution Retrospective Study.

Anterior shoulder approach of hydro-dilation technique by Yoong et al. had few issue rises from this technique; (i) administering an intra-articular shoulder injection through a thickened coracohumeral ligament result in significant resistance and patient discomfort, and (ii) risk of injecting into long head of biceps tendon is higher. This technical report is to describe a new approach using subacromial subdeltoid (SASD) bursa hydro-dilation at rotator interval instead of intra-articular injection. This technique utilizes fenestration of coracohumeral ligament followed by SASD hydro-dilation. Thirteen patients underwent the procedures reported significant outcomes in pain score (from mean VAS of 5.61 to 2, p value < 0.001) and range of motion (mean forward flexion from 76.61 degree to 149.07, p value < 0.001, and mean abduction from 60.61 degree to 94.61, p value < 0.001). This method presents a potentially less technically demanding and time-efficient alternative to existing treatments.

We aimed to compare the anterior and posterior approach for transtibial pull-out repair of medial meniscal posterior root tear (MMPRT) in terms of tibial tunnel positioning of the posterior horn, healing status, medial meniscal extrusion (MME), medial joint space (MJS) narrowing, and clinical outcomes. This retrospective study included patients who underwent arthroscopic transtibial pull-out repair for MMPRT between May 2019 and June 2023. Tibial tunnel positioning was assessed postoperatively using computed tomography. The healing status was evaluated using magnetic resonance imaging (MRI) at the 1-year follow-up visit. Pre- and postoperative MME and MJS widths were measured using MRI and weight-bearing radiography, respectively. Clinical outcomes were assessed preoperatively and at the 2-year follow-up using the International Knee Documentation Committee subjective score, Lysholm score, Knee Injury and Osteoarthritis Outcome Score, and Tegner activity scale. A total of 77 patients were initially evaluated for eligibility, of whom 23 were excluded. A total of 54 patients were analyzed (26 anterior approach (AA), 28 posterior approach (PA)). The PA group demonstrated significantly more accurate tibial tunnel positioning compared with the AA group (mean absolute distance: 2.8 ± 2.0mm versus 4.9 ± 3.2mm, p = 0.001). MRI at follow-up demonstrated that complete or partial healing was achieved in 88.9% of cases, with no significant difference between groups (p = 0.413). Overall, MME increased from 3.0 ± 0.9mm to 4.0 ± 1.6mm (p = 0.022) and MJS decreased from 3.5 ± 1.2mm to 3.1 ± 1.3mm (p = 0.001), without intergroup differences. All clinical scores improved significantly from baseline, but no significant differences were observed between approaches at final follow-up. The PA group achieved more accurate replication of the posterior horn insertion than the AA group; however, no definitive advantages were observed in short-term clinical or radiographic outcomes. III, retrospective comparative cohort study.

Background: Anterior odontoid screw fixation is a surgical technique for management of Type II odontoid fractures. The vertebral artery (VA) is located near odontoid process, making it more susceptible to injury during screw fixation. So, present study aimed to determine anatomical safe zone, which improves accuracy in screw fixation and enhances operative outcomes. Methods: This observational study was conducted in the Department of Anatomy at All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India. Total of 10 formalin-fixed cadaver necks were dissected. Inter-VA distances were measured from midline C2 to left and right sides of VA loops. Each measurement was repeated independently, and CT angiographic data were also analysed for comparison with cadaveric findings. Results: Inter-VA distance in cadavers ranged from 28 mm to 36.1 mm, with a mean of 32.95±2.72 mm. The mean distance from the C2 midline to right VA loop was 15.61±1.25 mm, while left measured 17.24±1.80 mm, indicating a relatively wider zone on left side. CT angiographic measurements demonstrated narrower inter-VA distances (mean 25.3±3.29 mm), significant anatomical variability and differences between in-vivo and cadaveric assessments. Conclusions: An accurate understanding of inter VA distance at the C2 level is critical for safe anterior cervical surgical approaches. Understanding these morphometric variations enables surgeons to anticipate high-risk areas and determine the optimal screw trajectory and size. As a result, pre-operative CT Angiography examination of the VA path is critical for reducing problems and ensuring optimal surgical outcomes at C2 level.

CORR Insights®: Frame-based Draping Technique for Standard Table Direct Anterior Approach THA: Efficient and Safe?

This study aimed to compare the acetabular component positioning accuracy and clinical outcomes between the direct anterior approach (DAA) and the posterolateral approach (PLA) for total hip arthroplasty (THA) in patients with a history of pelvic osteotomy. This retrospective study included 37 hips from 35 patients who underwent THA following pelvic osteotomy between 2005 and 2023. The primary outcomes were acetabular component positioning accuracy within the target zones and Japanese Orthopaedic Association (JOA) scores. The component angles were measured using postoperative computed tomography. The mean follow-up was 4.3 ± 3.0years in the DAA group (short- to mid-term outcomes) and 11.2 ± 3.6years in the PLA group (mid- to long-term outcomes). Significant improvement in JOA scores was observed in both groups, with no significant difference in final JOA scores. Mean inclination angles were similar with comparable variance. Although mean anteversion angles did not significantly differ, DAA demonstrated significantly lower variability. Optimal cup positioning within the target zones was significantly higher in the DAA group than in the PLA group. No dislocations occurred in the DAA group, whereas one did in the PLA group. Both approaches demonstrated comparable clinical outcomes. Although the DAA showed higher rates of optimal cup placement and improved anteversion angle consistency, the overall clinical results were similar. The DAA and PLA are valid options for THA after pelvic osteotomy.

Cage retropulsion is a severe complication of lumbar spinal fusion, causing neurological deficits and spinal instability. Current evidence on revision strategies is limited by small sample sizes, with no consensus on surgical planning. This retrospective study analyzed 14 patients (11 males, 3 females; mean age 57.2 ± 11.2 years) who underwent revision surgery for cage retropulsion (> 3mm posterior displacement) after lumbar fusion between 2013 and 2023. A novel 5-grade classification system (I-V) based on migration severity was proposed. Surgical approaches (anterior, n = 5; posterior, n = 9) were selected by revision timing, segment, and migration grade. Outcomes were assessed via VAS, ODI, and imaging; operative time, blood loss, and complications were recorded. 85.7% (12/14) patients showed clinical improvement: VAS decreased from 7.3 ± 1.2 to 2.3 ± 1.1, ODI from 69.5 ± 12.4% to 15.2 ± 8.7%. The average operation time for anterior approach was 215.0 ± 44.5min, and the average blood loss was 190.0 ± 156.2ml. The average operation time for posterior approach was 281.9 ± 90.9min, and the average blood loss was 387.5 ± 92.7ml. 50% (7/14) had complications, mainly transient abdominal distension (n = 5). 85.7% (12/14) achieved fusion at 78.9-month follow-up. This study proposes a practical classification system with preliminary feasibility in surgical approach selection for cage retropulsion. For symptomatic cases, early revision may yield better outcomes. Anterior surgery is recommended for L5-above segments with mild retropulsion, and posterior surgery is suggested for L5/S1 with severe retropulsion. In addition, anterior lumbar interbody fusion (ALIF) is a good option for L5/S1 with low-grade retropulsion when performed by experienced surgeon. Surgical success depends on tailored strategies considering revision timing, segments, and migration grade. But additional data are needed to confirm long-term safety and inform optimal management.

Background/Objectives: Hip hemiarthroplasty (HHA) for femoral neck fractures (FNFs) can be performed via the posterolateral approach (PLA), straight lateral approach (SLA) or direct anterior approach (DAA). However, the optimal approach remains unclear. This study evaluated mortality and return-to-home rates following an institutional transition from SLA to DAA. Methods: This retrospective observational cohort study included patients who underwent primary cemented unipolar hip hemiarthroplasty for FNF during a period of transition in surgical approach (2015-2023). Clinical outcomes between the straight lateral and direct anterior approach were compared. Primary outcomes were the mortality and return-to-home rates. Secondary outcomes included perioperative parameters and complications. A subgroup analysis was performed using Fracture Mobility Score (FMS) and Katz activities of daily living (ADL) index to compare functional outcomes. Results: Over a 9-year period, a total of 762 HHA were performed, of which 411 SLA and 333 DAA. Mortality at 90 days (14.1% vs. 8.7%, p = 0.029) and 1 year (26.5% vs. 17.7%, p = 0.005) were significantly higher in the SLA group. Among patients living at home preoperatively, return-to-home after surgery was lower for SLA compared to DAA (23.2% vs. 41.4%, p < 0.001). In terms of complications, SLA had significantly lower rates of periprosthetic joint infections (SLA n = 6 (1.5%) vs. DAA n = 15 (4.6%), p = 0.024). The decline in Katz ADL score at three months was significantly greater in the SLA group than in the DAA group (ΔKatz ADL -0.73 ± 1.57 vs. -0.11 ± 1.60, p = 0.036). Conclusions: Transitioning from SLA to DAA in HHA was associated with improved preservation of independent living, higher return-to-home rates and lower 90-day and 1-year mortality. However, DAA was also associated with higher rates of PJI.

ABSTRACT The caudate lobe (Couinaud segment I), owing to its deep location in the posterosuperior liver, intimate encirclement by the inferior vena cava (IVC), and close adjacency to the hepatic hilum and major hepatic veins, presents a formidable anatomical challenge for resection. Laparoscopic techniques, with their capacity for magnified, multi‐angled visualization, confer distinct advantages in navigating this complex region. The primary surgical approaches—the left‐side approach (optimal for the Spiegel lobe), the right‐side approach (suitable for the caudate process), and anterior transhepatic approach (providing direct access)—are selected based on tumor topography with combined strategies reserved for extensive lesions. Despite this methodological diversity, all laparoscopic caudate lobectomies are governed by common principles: (1) the indispensability of meticulous preoperative 3D imaging planning, (2) the critical need for systematic control of the short hepatic veins and hilar structures to mitigate hemorrhage risk, (3) the imperative of a stepwise, precise dissection technique to ensure safe pedicle isolation, and (4) the strategic utility of a combined major hepatectomy (e.g., with left or right hemihepatectomy) to simplify complex cases. Mastery of these approaches and strict adherence to these principles are paramount for achieving oncological radicality while maximizing the preservation of functional hepatic parenchyma in this high‐risk surgery.

BackgroundTotal ankle arthroplasty (TAA) is increasingly used as an alternative to arthrodesis for end-stage ankle arthritis. The extent to which implant bearing type and design evolution influence outcomes and survival remains debated.MethodsA systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD420251073944). PubMed, Embase, and Scopus were searched for English-language studies (2004-2025) reporting anterior-approach TAA with specified implant generation (I-IV) and bearing type (fixed [FB] vs mobile [MB]). Studies with a QualSyst score ≥ 75% were included. Primary outcomes were American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analogue scale (VAS), range of motion (ROM), complications, and revisions.ResultsForty-two studies comprising 4,271 implants were analyzed (FB: 1,546; MB: 2,725). Functional improvements were mainly driven by implant generation rather than bearing type. ΔAOFAS increased from 33.7 ± 22.3 in Gen II to 44.5 ± 28.3 in Gen IV (P < .001). ΔVAS varied across generations (Gen II 5.8 ± 2.1; Gen III 4.6 ± 2.8; Gen IV 5.46 ± 1.60; all P < .001 vs baseline). MB implants showed lower pre- and postoperative AOFAS scores but comparable ΔAOFAS to FB designs (36.4 vs 37.5; P = .358). MB systems provided greater pain relief (ΔVAS 5.62 vs 4.60; P < .001) but had higher revision rates (12.0% vs 6.2%; P < .001). FB implants achieved superior postoperative ROM gains in plantarflexion (+6.0° vs -2.9°; P < .001) and dorsiflexion (+2.71° vs +0.75°; P < .001). Excluding Gen I, complication rates decreased from 32.6% in Gen II to 18.8% in Gen III and 10.3% in Gen IV (all P < .01); revision rates declined from 16.5% (Gen II) and 9.6% (Gen III) to 0.5% (Gen IV) (P < .01).ConclusionsImplant generation is the primary determinant of outcomes, complications, and survival in anterior-approach TAA. Bearing type played a secondary role: MB devices provided greater pain relief, whereas FB systems achieved superior ROM recovery and lower revision risk. Fourth-generation implants yielded the most reliable results. Further prospective studies with standardized functional and kinematic assessments are warranted.Level of Clinical Evidence:Level I-Systematic Review/Meta-Analysis.

Abstract Background Lateral intra-ventricular tumors pose significant surgical challenges owing to their deep-seated location and close relationship with eloquent neural structures. The most commonly used surgical corridors include transcortical and transcallosal approaches. Although these techniques differ fundamentally in terms of cortical, callosal, and subcortical disruption, both continue to be widely utilized in the management of lateral ventricular tumors. The present study does not presuppose biological equivalence between these approaches; rather, it examines their practical clinical implications within a real-world surgical context, in which approach selection is influenced by factors such as tumor location and size, ventricular anatomy, and surgeon experience. The objective of this study is to compare postoperative functional outcomes and extent of resection achieved using both approaches. Results The study included 27 cases (16 males and 11 females). Mean age at diagnosis was 25.33 years (range 5–41). Followed-up for 12 months post-operative. Tumors were predominantly located in ventricular body ( n = 23) with fewer cases in frontal horn ( n = 4). Main pathologies were central neurocytomas (12 patients 44.4%), ependymomas (6 patients 22.2%), and subependymal giant cell astrocytoma (SEGA) (4 patients 14.8%). Excision was gross total resection (GTR) n = 15 (transcallosal group n = 8—transcortical group n = 7) and partial resection n = 10 (transcallosal group n = 4—transcortical group n = 6). 2 case mortalities were recorded. Postoperative intra-ventricular hemorrhage n = 17 (transcallosal group n = 10—transcortical group n = 7), Postoperative Glasgow coma Scale (GCS) 11.28 ± 3.59 range from (5–15), postoperative seizures n = 13 (transcallosal group n = 6—transcortical group n = 7), motor deficits ( n = 4), cognitive affection at 12th month postoperative n = 6 (transcallosal group n = 4—transcortical group n = 2), recurrence cases n = 7 (transcallosal group n = 4—transcortical group n = 3). Causes of death included postoperative intraventricular hemorrhage with refractory hydrocephalus ( n = 1), and systemic medical complications unrelated to the surgical procedure ( n = 1). Conclusions In our series, transcallosal approach was associated with a higher incidence of postoperative cognitive impairment compared with transcortical approach. No significant differences were observed between two approaches with respect to postoperative seizures, motor outcomes, GCS, or extent of resection. Additionally, partial tumor resection was associated with increased risk of postoperative hemorrhage and tumor recurrence.

Anterior lumbar interbody fusion (ALIF) is an effective treatment for lumbar degenerative diseases, but it usually requires combined posterior fixation. Currently, Currently, there is no high-strength fixation technique for single-position anterior approach. This study aimed to introduce L5 vertebral body screws combined with S1 vertebral body-pedicle screw fixation (BPSF) as a novel single-position anterior fixation technique for ALIF, and to evaluate its clinical and biomechanical outcomes. Sixty-three patients with L5/S1 degenerative disease undergoing ALIF were divided into BPSF (n = 22) and posterior pedicle screw fixation (PPSF, n = 41) groups. Clinical outcomes, radiographic parameters, and complications were collected and compared between groups. Biomechanically, an adult lumbar spine model was used to simulate two ALIF fixation configurations under normal and osteoporotic conditions. Each construct was loaded with 500N compression and 10N·m torque to simulate flexion/extension, lateral bending, and axial rotation. Kinematic analyses included ROM, interbody cage stress, and fixation device strain. The BPSF group showed significantly shorter operative duration (152.5min (127.5, 173.1) vs. 165.0min (140.0, 262.5), less intraoperative blood loss (115.0 ± 56.9ml vs. 160.0ml (110.0, 222.5) mL), and lower postoperative low back pain scores (1.6 ± 0.8 vs. 2.2 ± 0.7) compared to the PPSF group. And there were no statistically significant differences between the two groups in JOA improvement rate (49.9 ± 14.2% vs. 54.7 ± 18.1%), lumbar lordosis correction (6.9 ± 7.3° vs. 7.6 ± 7.1°), fusion rate (90.9% vs. 92.7%), or complication rate (27.3% vs. 19.5%). Biomechanically, BPSF reduced ROM during flexion (12% reduction) and axial rotation (63% reduction) compared to PPSF, with higher interbody cage stress but lower posterior fixation device stress under most loading conditions. BPSF provides safe anterior fixation for ALIF, reducing operative time and early postoperative pain. Its biomechanical stability, especially in rotational resistance, supports it as an alternative to PPSF for L5/S1 fusion.

Impact of Body Mass Index and Radiographic Parameters on Complications and Operative Times Comparing Anterior and Postero-lateral Approaches.

Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Despite its clinical importance, nationwide data on long-term hospitalization and surgical management trends in Germany remain scarce. A retrospective analysis was conducted using the German Federal Statistical Office's hospital discharge database covering all inpatient cases with the primary diagnosis of DCM (ICD-10-GM code M50.0) from 2005 to 2024. Annual case numbers, age and sex distributions, and surgical procedures were analyzed descriptively. Hospitalization rates per 100,000 inhabitants were calculated using mid-year population data. Between 2005 and 2024, approximately 70,000 hospital discharges with a primary diagnosis of DCM were recorded in Germany. Annual hospitalizations increased from 2,477 cases in 2005 to a peak of 4,076 cases in 2015, followed by a decline to 3,037 cases in 2024. Corresponding hospitalization rates rose from 3.0 to 4.96 per 100,000 inhabitants before decreasing to 3.7 per 100,000 in 2024. Segmented Poisson regression demonstrated a significant increase until 2015 followed by a significant decline thereafter. Age-specific analyses demonstrated a stable predominance of middle-aged and older adults, with consistently highest hospitalization volumes in patients aged 50-70 years. After age standardization to the 2015 reference population, the temporal pattern remained largely unchanged, indicating that observed trends were not solely attributable to population ageing. Mean length of hospital stay decreased steadily over time. Anterior surgical approaches accounted for the majority of procedures throughout the study period, while the proportion of surgically treated cases per hospitalization increased over time. This nationwide, discharge-based analysis demonstrates substantial temporal changes in hospitalizations and surgical treatment patterns for DCM in Germany over the past two decades. Hospitalization volumes increased until approximately 2015 and declined thereafter, a pattern that persisted after age standardization. DCM predominantly affected patients aged 50-70 years throughout the study period, without a pronounced shift toward progressively older age groups. The increasing ratio of surgical procedures to hospitalizations suggests more selective inpatient admissions focusing on operative management. These findings provide a descriptive reference for long-term hospitalization and surgical trends in DCM.

The pericapsular nerve group (PENG) block has proven to be an effective strategy for postoperative pain management in total hip arthroplasty (THA). However, its implementation requires specialized equipment and expertise, which limits its reproducibility. The objective of this study was to describe the technique of direct visualization-guided PENG block (PENG-DV) and assess its outcomes for postoperative pain control. A retrospective cohort study was conducted in patients who underwent THA through a direct anterior approach (DAA) and received the PENG-DV block as part of a standardized multimodal analgesia protocol. Demographic variables, pain score on the visual analogue scale (VAS), opioid consumption, muscle strength, and ambulation within the first 24h were evaluated. Of the 128 patients identified, 112 were included in the analysis. The cohort was predominantly female (60.7%), with a mean age of 63 years. The median postoperative VAS score was 2 and 3 at 12 and 24h respectively, increasing to 5 during physical therapy. By postoperative day one, 83.9% of patients ambulated, and most achieved muscle strength ≥ 3 for both hip flexion and knee extension. A total of 54.5% of patients required opioid rescue, with a mean morphine equivalent consumption of 10mg within the first 24h. PENG-DV for THA via DAA appears to be a promising strategy for effective pain control in the immediate postoperative period, as part of a multimodal analgesic approach designed to reduce opioid consumption and promote early mobilization.

The endoscopic direct anterior approach (Endo-DAA) for total hip arthroplasty (THA) aims to minimize soft-tissue trauma and accelerate recovery. Whether adding a disposable wound protector can further reduce early muscle injury and enhance recovery remains unclear. This randomized controlled trial evaluated the impact of wound protector use on biological, clinical, and functional outcomes after Endo-DAA THA. Seventy-six patients undergoing primary Endo-DAA THA were prospectively randomized (1:1) to either a wound protector or control group. The only intraoperative difference between groups was the use of a wound protector. The primary outcome was serum creatine kinase (CK) at 24h postoperatively. Secondary outcomes included serum myoglobin at 6h, C-reactive protein at 24h, pain visual analog scale (VAS) during activity, independent ambulation within 12h, lateral femoral cutaneous nerve (LFCN) symptoms, wound complications and satisfaction, and functional scores using the Harris Hip Score (HHS) and Forgotten Joint Score-12 (FJS-12). Statistical significance was defined as P < 0.05. Baseline characteristics were comparable between groups. The wound protector group had significantly lower postoperative CK (422.5 vs. 665.5 U/L; median difference: -228.0; 95% CI: -354.0 to -109.0; P < 0.001), myoglobin (299.9 vs. 481.2 ng/mL; P < 0.001), and C-reactive protein levels (30.3 vs. 45.1mg/L; P = 0.024). Pain scores were lower at 12 and 24h, and more patients achieved independent ambulation within 12h (86.8% vs. 55.3%; risk ratio [RR]: 1.57; 95% CI: 1.14 to 2.16; P = 0.002). Fewer wound complications (7.8% vs. 34.2%; RR: 0.23; 95% CI: 0.07 to 0.75; P = 0.005) and LFCN symptoms (36.8% vs. 65.7%; P = 0.012) were observed. Early functional scores were higher in the protector group, while midterm outcomes were similar. In Endo-DAA THA, the use of a disposable wound protector significantly reduced early muscle injury and systemic inflammation, alleviated immediate postoperative pain, facilitated earlier mobilization, and enhanced early wound healing and functional recovery without increasing operative time or hospital stay. These benefits were primarily observed during the early postoperative phase, which aligns with the principles of enhanced recovery after surgery. Chinese Clinical Trial Registry, ChiCTR2300076225. Registered on September 27, 2023.

This study explores the efficacy of different anterior and posterior cervical spine surgeries in the treatment of cervical thoracic disc protrusion. A retrospective analysis was conducted on 31 patients with cervical thoracic intervertebral disc herniation who underwent surgical treatment at the Spinal Surgery Department of the First Affiliated Hospital of Anhui Medical University from January 2018 to May 2022. According to the surgical method, it is divided into anterior group and posterior group. Compare the general situation of 2 groups of patients, record the surgical situation and postoperative complications of the 2 groups. The Japanese Orthopedic Association (JOA) scoring system and visual analog scale (VAS) pain scale were used to evaluate the preoperative and postoperative functional recovery of patients. Patients in the posterior group had longer surgical time and more intraoperative blood loss compared to those in the anterior group. At 12 months after surgery, the VAS scores of both groups significantly decreased (P < .01), and the anterior group was significantly lower than the posterior group (P < .01). The JOA score is the opposite. The incidence of postoperative complications in the posterior group was significantly higher than that in the anterior group. If the segment of intervertebral disc herniation at the cervical thoracic junction is located above the sternum stem, anterior cervical surgery can avoid splitting the sternum, achieve good decompression and fixation, and be beneficial for restoring the physiological curvature of the spine at the cervical thoracic junction, achieving satisfactory clinical results.