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Clip1:

The patient is positioned supine; thru' a transverse incision on the left side of the neck( to avoid the risk of recurrent laryngeal nerve injury thru' a right sided incision), the platysma is split and carotico-esophageal jn is dissected.

Clip2:

Dissection of the prevertebral tissues and the disc level is confirmed with a needle at the disc space  radiologically . 

The disc is incised and excised with punch; further excision with a vertebral spreader in place for better exposure. The posterior longitudinal ligament is visualized

Clip3:

The endplates are dissected away, and the posterior longitudinal ligament is separated away from the dura and excised with an up-cutting punch.

Clip 4:

The adjacent bone surfaces are freshened up to facilitate better fusion. A strut bone graft from the iliac crest is positioned and hammered down to position.