Anterior surgical approaches to the cervicothoracic junction: when to use the manubriotomy?

Background context: The cervicothoracic junction (CTJ) is always a difficult area for anterior approaches. Among them, low anterior cervical approach alone or combined with manubriotomy is the most frequently used.

Purpose: To study the need of manubriotomy.

Study design/setting: Comparison of last guidelines proposed in literature.

Patient sample: Seven patients treated between March 2010 and March 2011.

Methods: All the patients were scanned on with computed tomography and magnetic resonance of the spinal column before surgery. Measurements by Teng and Karikari were applied in all the cases. An illustrative case is showed.

Results: The anterior approaches to the CTJ are reviewed. The most recent guidelines by Teng and Karikari are easy to apply and careful. The results obtained were the same in all the cases with good outcome.

Conclusions: Manubriotomy permits a good exposure of the CTJ area with a low rate of complications. Either Teng and Karikari's guidelines can be used to estabilish the need of manubriotomy.