Anterior cervicothoracic junction surgery with partial sternotomy using an operative microscope
Hrabálek, L.; Vaverka, M.; Klein, J.
Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca 75(6): 465-470
2008
ISSN/ISBN: 0001-5415 PMID: 19150005 Document Number: 616077
The anterior cervical approach with partial sternotomy allows exposure of the lower cervical and upper thoracic spine. The use of a operative microscope provides a better view of the spine and safer and more radical performance while the surgical approach remains minimal. The authors describe this surgical procedure and present the illustrative histories of three patients with tumors between the first and the third thoracic vertebra. A good knowledge of upper mediastinum anatomy and magnetic resonance examination are the basic prerequisite for a successful operation without complications. On approach from the right side, the right recurrent laryngeal nerve should be protected, on approach from the left side of the esophagus, the thoracic duct should be identified and protected. The procedure is well tolerated by patients. For this surgery, co-operation of the spinal surgeon with thoracic or cardiovascular surgeons is recommended. Key words: cervicothoracic junction, tumors, anterior cervical approach, sternotomy, operative microscope.