Mini-open anterior approach for cervicothoracic junction fracture: technical note.

Area of Science:

• Orthopedic Surgery
• Spinal Surgery
• Geriatric Trauma

Background:

• Elderly patients with diffuse idiopathic skeletal hyperostosis (DISH) have increased fall risk and present challenges for treating 3-column unstable fractures.
• Cervicothoracic junction (CTJ) fractures in this population are linked to high morbidity and typically require surgical fixation via posterior approaches.

Observation:

• A novel, navigated, mini-open anterior surgical approach was utilized for fracture fixation.
• Intraoperative cone-beam CT scanning guided the placement of lag screws, followed by anterior plating.

Findings:

• The described anterior approach is less invasive and quicker than traditional open posterior methods.
• This technique successfully managed a cervicothoracic junction fracture in a 97-year-old patient.

Implications:

• This navigated anterior approach offers a viable, less invasive alternative for managing CTJ fractures in elderly, high-risk patients.
• It is particularly suitable for patients who cannot tolerate prone positioning during surgery, mitigating perioperative risks.