Berry's Ligament and the Inferior Thyroid Artery as reliable anatomical landmarks for the Recurrent Laryngeal Nerve (RLN): a fresh-cadaveric study of the cervical spine. The RLN relevant to spine

We found that the most reliable anatomical landmark for the RLN bilaterally was the ITA and Berry's ligament, both of which would be encountered as readily identifiable structures in anterior cervical spinal exposure before the nerve itself. We believe this will help spinal surgeons to refine their surgical technique to identify RLN where necessary, thus preventing iatrogenic injury. Our landmark protocol of FEEL-LOOK-AVOID can serve as an easy aide-mémoire for intraoperative surgical anatomy of the RLN during ACDF regardless of side.