title: Anterior Transsternal Approach for Treatment of Upper Thoracic Vertebral Osteomyelitis: Case Report and Review of the Literature.
abstract: Direct ventral access to the cervicothoracic spine (C7-T4) poses a technical challenge in spine surgery, given the vital neurovascular structures residing anterior to the cervicothoracic junction (CTJ). The transsternal approach is a feasible surgical option that allows for direct anterior exposure of the lower cervical and upper thoracic vertebrae. Here, the authors report a case of an elderly gentleman with upper thoracic (T1-2) vertebral osteomyelitis and epidural abscess who underwent a transsternal full median sternotomy for ventral decompression and fusion of C7-T2. We also detail our operative procedure and review relevant literature on different transsternal approaches to the CTJ.
authors.affiliation: Orthopedic Surgery, Massachusetts General Hospital ; Orthopaedics, Brigham and Women's Hospital.
authors.forename: Hai V
authors.initials: HV
authors.lastname: Le
authors.affiliation: Department of Neurological Surgery, UCSF Medical Center.
authors.forename: Rishi
authors.initials: R
authors.lastname: Wadhwa
authors.affiliation: Department of Neurological Surgery, UCSF Medical Center.
authors.forename: Praveen
authors.initials: P
authors.lastname: Mummaneni
authors.affiliation: Department of Thoracic Surgery, UCSF Medical Center.
authors.forename: Pierre
authors.initials: P
authors.lastname: Theodore
keywords: cervicothoracic junction; epidural abscess; median sternotomy; osteomyelitis; spine surgery; transsternal approach