gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Results of transsternal approach for lesions of the cervicothoracic junction

Meeting Abstract

  • Sedat Dalbayrak - Neurospinal Academy, Neurosurgery, Istanbul, Turkey
  • Onur Yaman - Tepecik Education and Training Hospital, Clinic of Neurosurgery, Izmir, Turkey
  • Mesut Yilmaz - Neurospinal Academy, Neurosurgery, Istanbul, Turkey
  • Sait Naderi - Umraniye Education and Training Hospital, Clinic of Neurosurgery, Istanbul, Turkey

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocDI.13.03

doi: 10.3205/14dgnc188, urn:nbn:de:0183-14dgnc1887

Published: May 13, 2014

© 2014 Dalbayrak et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



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.