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Sternal split approach to the cervicothoracic junction in children.

Kishore Mulpuri¹, Jacques G LeBlanc, Christopher W Reilly

¹Department of Orthopaedics, British Columbia's Children's Hospital, Vancouver, Canada. kmulpuri@cw.bc.ca

|June 2, 2005

Summary

A combined anterior neck and sternal splitting approach provides crucial access for treating severe cervicothoracic spinal deformities in pediatric patients, enabling stabilization and impeding curve progression.

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Area of Science:

Pediatric Spinal Surgery
Surgical Techniques for Spinal Deformity
Cervicothoracic Spine Surgery

Background:

Accessing multileveled spinal deformities at the cervicothoracic junction in pediatric patients is challenging.
Limited literature addresses surgical approaches for these complex cases.
Severe cervicothoracic kyphosis and/or scoliosis require effective stabilization strategies in children.

Observation:

A combined anterior neck and sternal splitting approach was utilized in six pediatric patients (ages 3-15).
Diagnoses included Klippel-Feil Syndrome, Proteus Syndrome, Larsen Syndrome, and neurofibromatosis type I.
The surgical technique provided access from C5 to T6 for instrumentation.

Findings:

The combined approach facilitated invaluable access to the cervicothoracic junction for complex spinal deformities.

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Surgical stabilization effectively impeded curve progression in pediatric patients.

Recurrent laryngeal nerve palsy was the sole significant complication in one patient.

Implications:

This surgical approach is effective for managing severe pediatric cervicothoracic spinal deformities.
The technique allows for multileveled access, crucial for complex cases.
Further research may explore long-term outcomes and refine this surgical strategy.