title: Results of the transsternal approach to cervicothoracic junction lesions.
abstract: OBJECTIVE
  Surgery for lesions involving the anterior column of the cervicothoracic junction is still challenging. The median transsternal approach provides a direct approach to this junction. The aim of this study was to present the results of cases operated using the median transsternal approach.
  
  
  METHODS
  There were 8 cases (7 males, 1 female) aged between 18-39 (mean 28.2) years. The compression to the spinal cord was secondary to trauma in 3 cases, infection in 3 cases, and tumor in 2 cases.
  
  
  RESULTS
  Median sternotomy was performed from the right side in 6 cases, and the left side in 2 cases. 14 level corpectomies were performed in 8 cases. Reconstructions were performed using a fibula allograft in 6 cases, and an iliac autograft in 2 cases. The mean follow-up duration was 104 months. A progressive delayed kyphosis requiring posterior stabilization occurred in one case. Postoperative neurological evaluation revealed improvement in 6 cases, and no change in 2 cases.
  
  
  CONCLUSIONS
  Median sternotomy is an appropriate and safe approach for selected cases with lesions involving the anterior column of the cervicothoracic junction. The sternal-splitting approach remains the best method for equal exposure of the anterior thoracic and cervical spine from C4 to Th4 vertebrae through a single incision.
authors.affiliation: Neurospinal Academy, Istanbul, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Dalbayrak
authors.forename: Onur
authors.initials: O
authors.lastname: Yaman
authors.forename: Mesut
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Sait
authors.initials: S
authors.lastname: Naderi
mesh_terms: D000293:Adolescent; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery; D056346:Sternotomy; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000473:pathology / Q000601:surgery