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Spinal disorders at the cervicothoracic junction

H S An1, A Vaccaro, J M Cotler

  • 1Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee.

Spine
|November 15, 1994
PubMed
Summary
This summary is machine-generated.

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This study of 36 patients highlights the challenges of cervicothoracic junctional problems, emphasizing careful diagnosis and surgical planning. Outcomes show improvement in incomplete deficits but frequent complications, underscoring meticulous technique and postoperative care.

Area of Science:

  • Spine surgery
  • Cervicothoracic junction disorders
  • Neurosurgery

Background:

  • Literature on cervicothoracic junctional problems is sparse.
  • This study represents the largest series to date on this subject.
  • Cervicothoracic junctional disorders encompass trauma, tumors, herniated discs, and instability.

Purpose of the Study:

  • To review cervicothoracic junctional disorders.
  • To analyze diagnostic methods and surgical approaches.
  • To evaluate surgical outcomes and associated complications.

Main Methods:

  • Retrospective review of 36 patients (C7-T3) undergoing surgery.
  • Patient conditions included trauma (18), tumors (15), herniated discs (2), and instability (1).
  • Surgical procedures involved posterior approaches (wiring, rodding, fixation) and anterior approaches (corpectomy, costotransversectomy).

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Main Results:

  • Average follow-up of 38 months for 33 patients.
  • Three postoperative deaths occurred.
  • Neurological improvement was significant in patients with incomplete deficits; complete injuries remained unchanged. Complications were frequent, including subluxation, pseudomeningocele, vocal cord paralysis, dysphagia, Horner's syndrome, infections, and tumor recurrence.

Conclusions:

  • Thorough clinical and radiological assessment is crucial to avoid diagnostic delays.
  • Surgeons must be familiar with anatomical landmarks and vital structures.
  • The cervicothoracic junction is prone to instability, especially post-trauma or laminectomy. Meticulous surgical technique and postoperative care are vital for preventing complications.