[Cervicomanubrial route for the ventral upper thoracic spine: technical note about six cases]

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Thoracic Surgery

Background:

• Ventrolateral cervicotomy presents challenges due to a narrowed surgical field for upper thoracic spine procedures.
• Anterior decompression and reconstruction are crucial for managing upper thoracic spinal cord compression.

Observation:

• This study reports on six patients undergoing ventral upper thoracic spinal cord decompression via the cervicomanubrial route.
• Procedures were performed between 2002 and 2007 for conditions including Pott's disease, metastases, fractures, and tumors, with lesions extending to T4.
• The surgical approach involves an anterior cervicotomy and manubriotomy, exposing the ventral spine from C5 to T4.

Findings:

• Five out of six patients experienced good outcomes following anterior spinal cord decompression, strut graft reconstruction, and osteosynthesis.
• The cervicomanubrial approach facilitated anterior decompression and reconstruction in the challenging upper thoracic region.
• Compared to sternotomy, cervicomanubriotomy demonstrated a less aggressive, safe, and reliable profile.

Implications:

• The cervicomanubrial route is a viable and less invasive surgical option for anterior thoracic spinal cord decompression.
• This approach may improve outcomes for patients with complex spinal pathologies in the cervicothoracic junction and upper thoracic spine.
• Further research could explore long-term outcomes and compare this technique with other surgical approaches.