An accurate determination of the optimal level of transverse skin incision is important. We describe a new technique to determine the level on the basis of computed tomography multiplanar reformations techniques, and conducted a randomized controlled trial to determine the accuracy of the new method. Eighty patients were enrolled and evenly divided into two groups. Patients in group A were marked by the traditional technique, whereas patients in group B were marked by the new method. Standard exposure procedures were performed. Intra-operative fluoroscopy confirmed if the intervertebral discs exposed were the intended ones. At the end of the study, intra-operative fluoroscopy confirmed that the intervertebral discs inserted with needles were not the intended ones in ten cases (25%) in group A. However, only three cases (7.5%) were wrongly located in group B. There was a significant difference between the two groups (P = 0.03). No severe complications were seen in either group. The current study provides a feasible method to identify the accurate level of transverse skin incision.
Keywords: anterior cervical surgery; computed tomography; multiplanar reformations techniques; skin incision.