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Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision

Spinal surgery of the anterior aspect of the cervicothoracic junction is difficult and has technological challenges because of the kyphotic alignment of the upper thoracic spine. This approach requires knowledge of the cervicothoracic regional anatomy. Surgery in this region is rare because of its i...

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Autores principales: Lee, Jin, Paeng, Sung Hwa, Lee, Won Hee, Kim, Sung Tae, Lee, Keun Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurotraumatology Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6495574/
https://www.ncbi.nlm.nih.gov/pubmed/31098349
http://dx.doi.org/10.13004/kjnt.2019.15.e8
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author Lee, Jin
Paeng, Sung Hwa
Lee, Won Hee
Kim, Sung Tae
Lee, Keun Soo
author_facet Lee, Jin
Paeng, Sung Hwa
Lee, Won Hee
Kim, Sung Tae
Lee, Keun Soo
author_sort Lee, Jin
collection PubMed
description Spinal surgery of the anterior aspect of the cervicothoracic junction is difficult and has technological challenges because of the kyphotic alignment of the upper thoracic spine. This approach requires knowledge of the cervicothoracic regional anatomy. Surgery in this region is rare because of its indications; despite this rarity, surgeons must be prepared to expose this region. In addition, surgery in this region demands extensive opening of the surgical field and results in severe postoperative pain. Therefore, a less invasive procedure must be considered. Six cases of cervicothoracic lesion operation have been reported. The patients were successfully treated using an anterior modified approach (J-type manubriotomy). Anterior reconstruction and instrumentation of the cervicothoracic junction offers a distinct advantage of a stable anterior implant bone construction while preserving the posterior osseo-ligamentous tension band. Moreover, the modified anterior approach (J-type manubriotomy) provides the same exposure of the cervicothoracic junction without a full median sternotomy and avoids injury to subclavian vessels during resection of the clavicle or sternoclavicular junction. Therefore, the anterior cervical approach combined with J-type manubriotomy allows extensive exposure of the cervicothoracic junction and causes less complications. We performed preoperative radiological evaluation to identify the cases in which J-type manubriotomy was necessary.
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spelling pubmed-64955742019-05-16 Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision Lee, Jin Paeng, Sung Hwa Lee, Won Hee Kim, Sung Tae Lee, Keun Soo Korean J Neurotrauma Case Report Spinal surgery of the anterior aspect of the cervicothoracic junction is difficult and has technological challenges because of the kyphotic alignment of the upper thoracic spine. This approach requires knowledge of the cervicothoracic regional anatomy. Surgery in this region is rare because of its indications; despite this rarity, surgeons must be prepared to expose this region. In addition, surgery in this region demands extensive opening of the surgical field and results in severe postoperative pain. Therefore, a less invasive procedure must be considered. Six cases of cervicothoracic lesion operation have been reported. The patients were successfully treated using an anterior modified approach (J-type manubriotomy). Anterior reconstruction and instrumentation of the cervicothoracic junction offers a distinct advantage of a stable anterior implant bone construction while preserving the posterior osseo-ligamentous tension band. Moreover, the modified anterior approach (J-type manubriotomy) provides the same exposure of the cervicothoracic junction without a full median sternotomy and avoids injury to subclavian vessels during resection of the clavicle or sternoclavicular junction. Therefore, the anterior cervical approach combined with J-type manubriotomy allows extensive exposure of the cervicothoracic junction and causes less complications. We performed preoperative radiological evaluation to identify the cases in which J-type manubriotomy was necessary. Korean Neurotraumatology Society 2019-04-22 /pmc/articles/PMC6495574/ /pubmed/31098349 http://dx.doi.org/10.13004/kjnt.2019.15.e8 Text en Copyright © 2019 Korean Neurotraumatology Society https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lee, Jin
Paeng, Sung Hwa
Lee, Won Hee
Kim, Sung Tae
Lee, Keun Soo
Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision
title Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision
title_full Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision
title_fullStr Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision
title_full_unstemmed Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision
title_short Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision
title_sort cervicothoracic junction approach using modified anterior approach: j-type manubriotomy and low cervical incision
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6495574/
https://www.ncbi.nlm.nih.gov/pubmed/31098349
http://dx.doi.org/10.13004/kjnt.2019.15.e8
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