Article
Results of transsternal approach for lesions of the cervicothoracic junction
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Published: | May 13, 2014 |
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Objective: The surgery for lesions involving anterior column of the cervicothoracic junction is still challenging. Median transsternal approach provides a direct approach to this junction. The aim of this study is to present results of cases who were operated using median transsternal approach.
Method: There were 8 cases (7 male, 1 female) aged between 18-39 (mean 28.2). The compression was secondary to trauma in 3 cases, to infection in 3 cases, and secondary to tumor in 2 cases.
Results: Median sternotomy was performed from right side in 6 cases, and from left side in 2 cases. 14 level corpectomy was performed in 8 cases. Reconstruction was performed using fibula allograft in 6 cases, and using iliac autograft in 2 cases. The mean follow-up duration was 104 months. A progressive delayed kyphosis occurred in one case, requiring posterior stabilization. Postoperative neurological evaluation revealed improvement in 6 cases, and no change in 2 cases.
Conclusions: It is concluded that median sternotomy is an appropriate and safe approach for selected cases with lesions involving anterior column of cervicothoracic junction. The sternal-splitting approach remains the best method for equal exposure of the anterior thoracic and cervical spine from C4 to Th4 vertebrae through a single incision.