• Mark D Johnson, Abhijith V Matur, Ferhan Asghar, Rani Nasser, Joseph S Cheng, and Charles J Prestigiacomo.
• Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA; Department of Neurological Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
• World Neurosurg. 2020 Mar 1; 135: 135-140.

AbstractThe debate over the influence approach sidedness has on the risk of recurrent laryngeal nerve palsy (RLNP) following anterior cervical discectomy and fusion (ACDF) has its origins with the introduction of the procedure for radicular pain in the 1950s. The recurrent laryngeal nerves follow disparate courses in the lower neck secondary to differences in embryogenesis. Because of these differences, some authors believe a right-sided approach increases the risk of RLNP. However, modern surgical series have not shown a clear risk of RLNP with a right- versus left-sided approach. By looking at the historical context surrounding the introduction of ACDF, we propose the dogmatic view of an increased risk of RLNP with a right-sided approach likely arose from a combination of theoretical anatomic risk and the early surgical experience of a pioneer of the procedure.Copyright © 2019 Elsevier Inc. All rights reserved.

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