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Trans-upper-sternal approach to the cervicothoracic junction.

Yi-Lin Liu1, Ying-Jie Hao, Tao Li

  • 1Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China.

Clinical Orthopaedics and Related Research
|August 30, 2008
PubMed
Summary

The trans-upper-sternal approach offers excellent surgical exposure for cervicothoracic lesions, leading to improved neurologic function in all patients. Careful technique is vital to prevent nerve and duct injuries.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Cervicothoracic lesions present surgical challenges due to limited exposure.
  • The trans-upper-sternal approach is a technique for accessing this region.

Purpose of the Study:

  • To evaluate the efficacy and safety of the trans-upper-sternal approach for treating cervicothoracic lesions.
  • To assess patient outcomes, including neurologic function and complications.

Main Methods:

  • Surgical treatment of 11 patients with cervicothoracic lesions using the trans-upper-sternal approach.
  • Combined cervicothoracic incision and upper sternotomy for tumor resection, vertebral removal, and spinal cord decompression.
  • Spinal stabilization and neurologic assessment using the Frankel classification.

Main Results:

  • All patients demonstrated improved neurologic function post-surgery.
  • One case of chyle leak and one of transient vocal cord paresis occurred, both resolved.
  • No nonunions or instrument-related complications were observed; spinal stability was maintained.

Conclusions:

  • The trans-upper-sternal approach provides excellent exposure for cervicothoracic junction reconstruction.
  • Meticulous surgical technique is necessary to minimize risks such as recurrent laryngeal nerve and thoracic duct injury.