Retrospective, descriptive and analytical study of 34 patients, women 18, men 16; average age 50.8 years, with diagnosis of degenerative and isthmic spondylolisthesis (with degenerative component), Treated surgically with transpedicular fixation (FT) + arthrodesis Posterolateral (APL), in the Department of Neurosurgery of the Guillermo Almenara National Hospital between January 1966 and December 2004.

The authors report six cases in which, was used an trans oral technique to deal with the upper cervical spine segment. The cases were: four cases of rheumatoid arthritis and 2 cases of basilar impression. We described the clinical picture and the surgical technique
used. Then we described the techniques used for posterior stabilization in each case.

The main cause of death and sequelae of patients with a subarachnoid haemorrhage (SAH) due to rupture of a cerebral aneurysm, and who manage to reach a specialized center, is still ischemia or ischemic deficit Delayed (IDD) secondary to cerebral vasospasm.

Neurotization of the suprascapular and musculocutaneous nerves with the accessory spinal, phrenic and intercostal nerves show good results. In case of incomplete injury, the neuromuscularisation technique of the musculocutaneous with the ulnar (Oberlin) should also be considered. Unlike what happens at the facial level, the hypoglossal is not useful for neurotizing the brachial plexus.