Turkish Neurosurgery 2014 , Vol 24 , Num 5
Results of the Transsternal Approach to Cervicothoracic Junction Lesions
Sedat DALBAYRAK1, Onur YAMAN2, Mesut YILMAZ1, Sait NADERI3
1Neurospinal Academy, Istanbul, Turkey
2Tepecik Education and Training Hospital, Clinic of Neurosurgery, Izmir, Turkey
3Umraniye Education and Training Hospital, Clinic of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.9753-13.1 AIM: Surgery for lesions involving the anterior column of the cervicothoracic junction is still challenging. The median transsternal approach provides a direct approach to this junction. The aim of this study was to present the results of cases operated using the median transsternal approach.

MATERIAL and METHODS: There were 8 cases (7 males, 1 female) aged between 18-39 (mean 28.2) years. The compression to the spinal cord was secondary to trauma in 3 cases, infection in 3 cases, and tumor in 2 cases.

RESULTS: Median sternotomy was performed from the right side in 6 cases, and the left side in 2 cases. 14 level corpectomies were performed in 8 cases. Reconstructions were performed using a fibula allograft in 6 cases, and an iliac autograft in 2 cases. The mean follow-up duration was 104 months. A progressive delayed kyphosis requiring posterior stabilization occurred in one case. Postoperative neurological evaluation revealed improvement in 6 cases, and no change in 2 cases.

CONCLUSION: Median sternotomy is an appropriate and safe approach for selected cases with lesions involving the anterior column of the cervicothoracic junction. The sternal-splitting approach remains the best method for equal exposure of the anterior thoracic and cervical spine from C4 to Th4 vertebrae through a single incision. Keywords : Cervicothoracic junction, Transsternal approach, Anterior

Corresponding author : Onur Yaman, dronuryaman@yahoo.com