Anterior cervicothoracic junction corpectomy and plate fixation without sternotomy

Area of Science:

• Neurosurgery
• Spinal Surgery
• Orthopedic Surgery

Background:

• Anterior cervical decompression and reconstruction are established procedures.
• The use of anterior instrumentation and bone grafts via a low cervical approach for cervicothoracic pathologies remains less documented.

Observation:

• Twenty-one patients underwent anterior cervicothoracic decompression, fusion, and fixation using a low cervical incision.
• Eight patients required corpectomy (C7-T4) through this approach.
• All patients received an allograft bone strut and anterior locking plate fixation.

Findings:

• No new neurological deficits occurred postoperatively.
• Significant improvement was noted in 3 of 4 patients with preoperative deficits.
• Complications included recurrent laryngeal nerve palsy (2 patients, 1 permanent), instrumentation failure (1 patient), and superficial wound infection (2 patients).

Implications:

• Anterior decompression, fusion, and fixation can be safely performed via a cervical incision, potentially reducing morbidity compared to sternotomy or lateral extracavitary approaches.
• Careful preoperative assessment of mediastinal anatomy is crucial for patient safety.
• This technique offers a less invasive option for anterior cervicothoracic spinal procedures.