[Combined anterior and posterior approach in surgical treatment of tumors at the cervicothoracic junction: our experience].
BACKGROUND
In the past, surgery of the pathologies of cervicothoracic junction carried high risk. Better knowledge of the anatomical situation and the increasing experience with anterior approach, corpectomy and spinal stabilization instruments have all made possible to remove the tumours of the cervicothoracic junction in a combined way.


METHODS
The authors present six cases of spinal tumours where removal was done via anterior approach with partial clavicle and sternal resection. In two cases the anterior approach were combined with posterior tumour removal and fixation. Two of the cases were metastatic tumours, one lymphoma, one osteochondroma, one giant cell osteoid tumour and one malignant neurogenic tumour. The ventral approach gave a relatively wide window to explore the tumours and with the help of the operative microscope the tumour removal went fairly well. After total removal of the tumours the cervical spine were stabilized with own clavicle or iliac bone graft, titanium plate and screws. In patients with three-column involvement posterior fixation was made. The immediate recovery of the patients was well and there were no postoperative complications. Postoperative CT and MRI scans have great value in the early control after surgery as well as for the follow up of the patients.


CONCLUSIONS
The anterior approach with partial clavicle and sternal resection combined with posterior approach and fixation seems to be feasible and safe method to explore and remove cervicothoracic junction pathologies.
Banczerowski
Péter
P
Országos Idegsebészeti Tudományos Intézet, H-1145 Budapest, Amerikai út 57. bancpet@ethernet5.oiti.hu
Lipóth
László
L
Veres
Róbert
R
D000328:Adult; D016025:Bone Transplantation; D002574:Cervical Vertebrae; D002648:Child; D002968:Clavicle / Q000601:surgery; D005260:Female; D005870:Giant Cell Tumors / Q000601:surgery; D006801:Humans; D006814:Hungary; D007085:Ilium / Q000637:transplantation; D008223:Lymphoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009380:Neoplasms, Nerve Tissue / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D015831:Osteochondroma / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000556:secondary / Q000601:surgery*; D013249:Sternum / Q000601:surgery; D013904:Thoracic Vertebrae; D016896:Treatment Outcome