Results of transsternal approach to the cervicothoracic junction lesions

Dalbayrak, Sedat; Yaman, Onur; Yılmaz, Mesut; Naderi, Sait

doi:10.5137/1019-5149.jtn.9753-13.1

Cited by 6 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zeng et al compared the clinical curative effect of cervicothoracic spinal tuberculosis by anterior, anterior-posterior, and posterior approaches, and they found that the postoperative local recurrent deformity rate for the simple anterior approach was highest [ 5 ]. However, other studies have confirmed the curative effect of the anterior approach in cervicothoracic disease, especially in spinal tuberculosis [ 9 – 11 ]. The posterior approach to the cervicothoracic junction is disadvantageous because of the destabilization effect, inadequate visualization of the pathology, and need for a long posterior construct to restore stability.…”

Section: Discussionmentioning

confidence: 99%

Surgical approach and management outcomes for junction tuberculous spondylitis: a retrospective study of 77 patients

et al. 2018

View full text Add to dashboard Cite

BackgroundJunction tuberculous spondylitis involves the stress transition zone of the spine and has a high risk of progression to kyphosis or paraplegia. Problems still exist with treatment for spinal junction tuberculosis. This study investigated the surgical approach and clinical outcomes of junction spinal tuberculosis.MethodsFrom June 1998 to July 2014, 77 patients with tuberculous spondylitis were enrolled. All patients received 2–3 weeks of anti-tuberculous treatment preoperatively; treatment was prolonged for 2–3 months when active pulmonary tuberculosis was present. The patients underwent anterior debridement and were followed up for an average of 29.4 months clinically and radiologically.ResultsThe cervicothoracic junction spine (C7-T3) was involved in 15 patients. The thoracolumbar junction spine (T11-L2) was involved in 39 patients. The lumbosacral junction spine (L4-S1) was involved in 23 patients. Two patients with recurrence underwent reoperation; the drugs were adjusted, and all patients achieved bone fusion. The preoperative cervicothoracic and thoracolumbar kyphosis angle and lumbosacral angle were 31.4 ± 10.9°, 32.9 ± 9.2°, and 19.3 ± 3.7°, respectively, and the corresponding postoperative angles were ameliorated significantly to 9.1 ± 3.2°, 8.5 ± 2.9°, and 30.3 ± 2.8°. The preoperative ESR and C-reactive protein level of all patients were 48.1 ± 11.3 mm/h and 65.5 ± 16.2 mg/L which decreased to 12.3 ± 4.3 mm/h and 8.6 ± 3.7 mg/L at the final follow-up, respectively. All patients that had neurological symptoms achieved function status improvement at different degrees.ConclusionFor spinal tuberculosis of spinal junctions, anterior debridement, internal fixation, and fusion can be preferred and achieved. If multiple segment lesions are too long or difficult for operation of anterior internal fixation, combining posterior pedicle screw fixation is appropriate.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical approach and management outcomes for junction tuberculous spondylitis: a retrospective study of 77 patients

et al. 2018

View full text Add to dashboard Cite

show abstract

“…However, it is still difficult to decompression severe direct anterior spinal cord compression [5,6]. And other direct upper thoracic vertebral approaches can be mainly divided into the high transthoracic approach (C6-T4), and the modified anterior approach (C3-T4) [7,8]; however, using these approaches, it is not easy to decompress the spinal cord at the upper thoracic (T1-T4) level of the anterior column and difficult to create an adequate operative space because of the scapula block [3,9,10].…”

Section: Introductionmentioning

confidence: 99%

Right infraaxillary thoracotomy approach for upper thoracic vertebral decompression and fusion at T2–T6 levels: a technical note

Liu

Huang

et al. 2018

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…Mihir et al 37 have documented 11 patients with unacceptable cosmetic results and superficial infections that mostly healed within a week after surgery with regular dressings and proper antibiotics. On the other hand, almost all patients who experienced RLN palsy postoperatively showed complete recovery within months except two patients, one in Mihir et al 36 study and another in Flavigna et al 14 study who did not recover from RLN palsy. In contrast, after the posterior approach, complications were mostly due to lung affection.…”

Section: Egy Spine J -Volume 38 -April 2021mentioning

confidence: 87%

“…The total number of patients in all the included studies was 419; 234 were males (55.8%) and 185 were females (44.2%). The average age of all patients was 47 years, with the youngest mean age being 28.1 years in Dalbayrak et al 14 and the oldest mean age 63 years in Falavigna et al 19 The average follow-up time of all patients was 40 months. The summary of patients and study characteristics is shown in Table 1.…”

Section: Patients and Study Characteristicsmentioning

confidence: 95%

Outcome of Surgical Fixation to Cervicothoracic Junction: A Systematic Review of Literature

Fooz

Khattab

Maziad

2021

Egyptian Spine Journal

View full text Add to dashboard Cite

Background Data: Surgical fixation of the cervicothoracic junction (CTJ) is difficult due to the complex anatomy and biomechanical properties of this area. Several important vascular, visceral, and soft tissue structures make access to this region challenging; therefore, knowledge of these structures is essential for decompression and fixation. The posterior approach is commonly used in many diseases of the spine but is inadequate when targeting the anterior spinal elements; thus, it can result in a higher complication rate and can disturb spinal stability. For these reasons, different posterolateral and anterior approaches have been developed. Study Design: Systematic review of the literature Purpose: To compare these different anterior and posterior surgical approaches to the CTJ, indicating pathologies, outcomes, and complications. Patients and Methods: This review was done using the standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. An initial search has been carried out using PubMed, Embase, Cochrane Library, Ovid, Scopus, and Google Scholar databases using the following keywords; cervicothoracic junction, C7/T4, surgical fixation; posterior approach; anterior approach. Results: Our systematic review yielded 12 studies with 419 patients that met our inclusion criteria, including seven studies using the anterior and five posterior approaches for treating different spinal pathologies. In this review, most patients with traumatic and neoplastic injuries were treated through the anterior approach, and those with degenerative and infectious diseases were treated through the posterior one. Assessment of the reported neurological status change pre-and postoperatively showed a significant difference between the anterior and posterior groups favoring the anterior one, and the rate of complications of the posterior approach was higher than that in the anterior approach. Conclusion:The data in this review may demonstrate both the effectiveness and safety of the anterior approach compared to the posterior one. These data indicate that patients who underwent the anterior approach have a higher incidence of improvement in their neurological functions and that complications in the anterior group are relatively less than those in the posterior one.

show abstract

Results of transsternal approach to the cervicothoracic junction lesions

Cited by 6 publications

References 11 publications

Surgical approach and management outcomes for junction tuberculous spondylitis: a retrospective study of 77 patients

Surgical approach and management outcomes for junction tuberculous spondylitis: a retrospective study of 77 patients

Right infraaxillary thoracotomy approach for upper thoracic vertebral decompression and fusion at T2–T6 levels: a technical note

Outcome of Surgical Fixation to Cervicothoracic Junction: A Systematic Review of Literature

Contact Info

Product

Resources

About