Expansile manubriotomy for ventral cervicothoracic junction disease

Area of Science:

• Neurosurgery
• Thoracic Surgery
• Spinal Surgery

Background:

• Anterior approaches to the cervicothoracic junction can cause significant morbidity.
• Ventral vertebral body disease in this region requires effective surgical access.

Purpose of the Study:

• To evaluate the feasibility and outcomes of expansile manubriotomy for anterior cervicothoracic junction disease.
• To assess the morbidity associated with this anterior surgical approach.

Main Methods:

• Expansile manubriotomy and corpectomy were performed on twelve patients with ventral cervicothoracic junction disease (T1-T3 levels).
• Surgical steps included midline manubrial division, lateral extension, and dissection to access the prevertebral fascia.
• Eleven patients underwent fusion, and one had an oblique corpectomy.

Main Results:

• The procedure was technically feasible and successfully completed in all patients.
• The approach provided adequate exposure for ventral disease affecting the T1-T3 vertebral bodies.
• One patient with comorbidities (diabetes, end-stage renal disease, epidural abscess) died postoperatively.

Conclusions:

• Expansile manubriotomy is a technically feasible, less invasive, and low-morbidity anterior approach for accessing ventral disease above the T4 level.
• This technique is a viable option for managing anteriorly located pathologies in the cervicothoracic spine.