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Modified Transclavicular-Transmanubrial Approach to Cervicothoracic Spine: Revisiting and Renovating the Path -

T S Vasan¹, Raghavendra M Rao¹

¹Department of Neurosurgery, JSS Medical College and Hospital, Mysuru, Karnataka, India.

Asian Journal of Neurosurgery

|March 12, 2021

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The modified transclavicular transmanubrial approach offers a safe and effective anterior surgical option for cervicothoracic spine pathology, leading to improved neurological function and preserved shoulder stability.

Area of Science:

Neurosurgery
Orthopedic Surgery
Spinal Surgery

Background:

Approaching the cervicothoracic spine junction requires detailed knowledge of vital structures.
The viscero-neurovascular space is a common surgical corridor.
This study details experience with a modified anterior approach for cervicothoracic pathology.

Purpose of the Study:

To evaluate the efficacy of a modified transclavicular transmanubrial approach for cervicothoracic spine pathology.
To assess neurological outcomes and surgical safety.
To explore novel surgical corridors for the lower cervicothoracic junction.

Main Methods:

Retrospective review of 10 patients with upper thoracic vertebral body disease (Feb 2011-Aug 2015).
Clinical and radiological evaluation, including Frankel grading of neurological status.

Keywords:

Cervicothoracic spine transclavicular-transmanubrial approach tuberculosis spine

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Follow-up with histopathological reports and tailored treatment.

Main Results:

Significant neurological improvement (1-2 Frankel grades) in most patients post-operatively.
Patients with metastatic disease maintained their pre-operative neurological grade.
The modified approach facilitated access to the cervicothoracic spine.

Conclusions:

Anterior approaches, particularly modified ones, are biomechanically advantageous for cervicothoracic spine pathology.
These approaches allow for effective decompression and stabilization.
The technique preserves shoulder girdle stability, yielding good neurological and cosmetic results.