In some instances, the most direct approach to the upper cervical spine is through the oral cavity. One of the challenges of the transoral approach has been the possibility of infection because the mouth is clearly not a sterile area. A recent paper by Dr. Shousha in the journal Spine reports that the infection rate is 3.6%. This is much less than had previously been thought and puts into greater perspective the risk for those patients who require this approach.
Dr. Jack Stern