Simple method for determining the need for sternotomy/manubriotomy with the anterior approach to the cervicothoracic junction

Neurosurgery
Isaac O KarikariRobert E Isaacs

Abstract

Frequently, the cervicothoracic junction can be reached through a simple anterior approach. In some cases, access to this region requires a much more aggressive surgical intervention, such as manubriotomy or sternotomy. Information regarding the need for such interventions is particularly useful to have preoperatively to guide surgical planning as well as discussions regarding surgical risks and expected morbidities. Whereas methods utilizing magnetic resonance imaging have been proposed for determining the lowest level that can be accessed through a simple low cervical approach, we describe a simple technique using sagittal computed tomographic imaging. Our technique does not require any complex geometry and has given us very consistent results. Computed tomographic sagittal reconstruction of the cervical and upper thoracic spine that includes the entire sternum is obtained. The lowest accessible disc space is determined by a straight line passing through and parallel to the disc space that also passes above the manubrium (the intervertebral disc line). Sagittal computed tomographic reconstructions obtained from 50 adult patients were reviewed, and the lowest disc space accessible from an anterior low cervical approach was det...Continue Reading

References

Aug 25, 2004·Neurosurgical Focus·Hoang LeDaniel Kim
Nov 14, 2006·The Spine Journal : Official Journal of the North American Spine Society·Samir Lapsiwala, Edward Benzel
Jun 9, 2007·Neurosurgery Clinics of North America·Vincent Y Wang, Dean Chou

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Citations

Apr 4, 2013·The Spine Journal : Official Journal of the North American Spine Society·Roberto TarantinoRoberto Delfini
Mar 5, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Liujun ZhaoNabil A Ebraheim
Jul 15, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kamran V SattarovAli A Baaj
Jun 2, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Weerasak SinghatanadgigeK Daniel Riew

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