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KMID : 0604620060130020043
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Dongguk Journal of Medicine
2006 Volume.13 No. 2 p.43 ~ p.51
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Surgical Considerations in Posterior Stabilization of the Cervicothoracic Junction
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Kim Jin-Wook
Jung Joo-Ho
Park Yong-Seok
Lee Kyu-Chun
Lee Young-Bae
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Abstract
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Cervicothoracic junction is where the mobile lordotic cervical spine joins the rigid kyphotic thoracic spine. It is a complex potentially unstable anatomic site with unique biomechanical properties. The purpose of this article is to discuss posterior stabilization of the cervicothoracic junction. Three patients who underwent cervicothoracic arthrodesis were reviewed from November 2004 to July 2006. The authors have tried anterior and posterior fusion after neural decompression and reduction. Two patients have been stabilized at cervicothoracic junction but one elder patient expired only after posterior reduction and stabilization because of the complications by associated injuries. In conclusion, posterior instrumentation is difficult at the cervicothoracic junction. Lateral mass fixation can be considered for C3-C6 and pedicle screw fixation can be considered for caudal to C6. In assembling a cervicothoracic construct, one must take into account that the offset between the laterally directed lateral mass screws and the medially directed pedicle screws. Further, a full understanding of the advantage and disadvantages of the potential instrumentation systems helps in avoiding unanticipated instrumentation limitations and prolonged operative times.
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KEYWORD
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cervicothoracic junction, instrumentation, pedicle screw, lateral mass screw, posterior stabilization
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