Mini-open anterior approach to the cervicothoracic junction: a cadaveric study

Area of Science:

• Spinal Surgery
• Anatomical Studies
• Surgical Techniques

Background:

• The cervicothoracic junction (CTJ) presents surgical challenges due to its complex anatomy and proximity to vital structures.
• Minimally invasive approaches are increasingly sought after to reduce surgical morbidity.

Purpose of the Study:

• To evaluate the feasibility of a novel mini-open anterior approach to the cervicothoracic junction (CTJ).
• To determine the extent of exposure achievable with this technique in cadaveric models.

Main Methods:

• Utilized four adult fresh-frozen cadaveric specimens.
• Created an osteotomy window in the manubrium sterni to overcome bony obstruction.
• Employed specific surgical corridors, navigating between the brachiocephalic artery and vein, or the aorta and superior vena cava.
• Incorporated a self-retaining retractor system and an endoscope to aid visualization and manipulation.

Main Results:

• Successfully exposed the cervicothoracic junction (CTJ) in all four cadaveric specimens using the mini-open anterior approach.
• Achieved visualization and access to the anterior surface of vertebrae C6 through T5.
• Demonstrated the capability for complete decompression and fixation (e.g., locking plate and screws) within the exposed region.
• Identified the T5 vertebral body as the most caudal level accessible via this anterior approach.

Conclusions:

• The mini-open anterior approach is a feasible technique for exposing the cervicothoracic junction (CTJ).
• This approach offers a viable option for surgical interventions requiring access to the C6-T5 vertebral segments.