title: Stabilization of the cervicothoracic junction in tumoral cases with a hybrid less invasive-minimally invasive surgical technique: report of two cases.
abstract: BACKGROUND
  Literature about long constructs in the cervicothoracic junction (CTJ) implanted with a minimally invasive surgical technique is practically nonexistent. Our objective is to present a less invasive-minimally invasive (LIS-MIS) surgical technique to stabilize the CTJ.
  
  
  METHODS
  A midline cervical short incision was made, three or four level lateral mass screws were inserted bilaterally and rods were placed in a conventional technique (LIS field). Percutaneous screws were placed in the upper thoracic spine, and thoracic rods were threaded subfascially through the pedicle sleeves up to the cervical incision (MIS field). Cervical and thoracic rods were linked with parallel connectors. Two cross-links were used in each case.
  
  
  RESULTS
  Two patients (33 and 53 years of age) with instability of the CTJ due to metastases were operated on in this way without attempting bone fusion. Mean duration of surgery was 7.5 hours. No patient required blood transfusion. There were no complications related to surgery or the hardware. Opioid consumption diminished after surgery, and both patients remained ambulatory until decease.
  
  
  CONCLUSIONS
  This LIS-MIS technique seems feasible to stabilize the CTJ in very selected cases when fusion is not necessary.
authors: Department of Neurosurgery, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain.
authors: Hector
authors: H
authors: Roldan
authors: Department of Neurosurgery, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain.
authors: Juan Christian
authors: JC
authors: Ribas-Nijkerk
authors: Department of Neurosurgery, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain.
authors: Luis
authors: L
authors: Perez-Orribo
authors: Department of Neurosurgery, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain.
authors: Victor
authors: V
authors: Garcia-Marin
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators / Q000706:statistics & numerical data*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D011859:Radiography; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome