title: Modified anterior approach to the cervicothoracic junction.
abstract: The surgical management of tumors at the cervicothoracic junction is hindered by various anatomic structures. Standard approaches to the cervical or thoracic spine provide inadequate exposure. An approach to the cervicothoracic junction that provides exposure from C3 to T4 is described. The approach allows extensive bony resection, spinal cord decompression, correction of deformity, spinal reconstruction, and stabilization. Four patients with tumors metastatic to the cervicothoracic junction underwent this surgical approach. All had significant kyphosis and neck pain unresponsive to nonsurgical treatment. After surgery, neurologic function improved in three patients and remained normal in one. All patients had relief of neck pain and reduction of kyphosis.
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan.
authors.forename: L T
authors.initials: LT
authors.lastname: Kurz
authors.forename: S E
authors.initials: SE
authors.lastname: Pursel
authors.forename: H N
authors.initials: HN
authors.lastname: Herkowitz
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000556:secondary; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000556:secondary; D011859:Radiography; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D013909:Thorax