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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 839-845
DOI: 10.4103/ajns.AJNS_178_20
Original Article

Modified transclavicular-transmanubrial approach to cervicothoracic spine: Revisiting and Renovating the Path – Lessons learned

T Vasan
Department of Neurosurgery, JSS Medical College and Hospital, Mysuru, Karnataka
,
Raghavendra Rao
Department of Neurosurgery, JSS Medical College and Hospital, Mysuru, Karnataka
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Introduction: A thorough knowledge of the vital structures adds to the safety in approaching the cervicothoracic spine junction. The best described method to reach the spine is via viscero-neurovascular space. We present our experience of 10 cases operated at our institute using the modified transclavicular transmanubrial approach to the cervicothoracic spine pathology.As we gained experience we have used various corridors to the operating field and used a new space to approach the lower cervicothoracic junction spine. Methods: Between February 2011 to August 2015, 10 patients with disease in upper thoracic vertebral body were admitted and evaluated clinically and radiologically. Neurological status in all cases was graded according to Frankel grading system.Patients were followed up with Histopathological reports and treated accordingly. Results: All patients(except metastasis) improved by 1 or 2 grade in post op period. Metastasis patients remained in same grade. Conclusion: Anterior approach with its modifications are the better suited biomechanically for exploring the pathology of cervicothoracic spine,its decompression and stabilization. Also it preserves the stability of shoulder girdle with good neurological and cosmetic outcome.

Key-words:

Cervicothoracic spine - transclavicular-transmanubrial approach - tuberculosis spine

Financial support and sponsorship

Nil.




Publication History

Received: 26 April 2020

Accepted: 24 August 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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