spine 3 insert a guide pin 155 1 percutaneously into the superior facet perpendicular to the spine 4 measure depth skin to joint on the scaled guide pin 155 1 7 insert a guide pin 155 2 down to the disc space 9 insert the working tube 35 and obturator 33 combination 13 use a round or oval shaped retractor or lower tube hemicylindrical portion 65 and 69 as inserts preferably with distal end cutouts in each 1 the patient is placed in a prone position on a jackson table 3 percutaneously insert guide pin 155 with ap and lateral fluoroscopic views 5 apply the working tube 35 with obturator 33 into the incision 7 advance the working tube 35 and collapse and remove the obturator 33 8 proceed with surgery type of sleeve or lower tube hemicylindrical portion 65 should be round or oval with slanted and to match the slanted lamina 9 for application for lateral mass plating use an oval working tube 35 for a greater exposure 1 begin with standard anterior cervical diskectomy fusion approach with a incision on the left or right side of the neck 2 blunt finger dissection is performed between the lateral vascular structures and the medial strap muscle and visceral structures down to the prevertebral fascia 3 establish the correct level to be operated on fluoroscopically and the guide pin 155 inserted into the disc 4 apply the working tube 35 and obturator 33 combination and dock at the proper level of the anterior sping 5 open.