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首页> 美国卫生研究院文献>Korean Journal of Neurotrauma >Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision
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Cervicothoracic Junction Approach using Modified Anterior Approach: J-type Manubriotomy and Low Cervical Incision

机译：颈前路交界处改良前路入路：J型手法切开术和低宫颈切口

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摘要

Spinal surgery of the anterior aspect of the cervicothoracic junction is difficult and has technological challenges because of the kyphotic alignment of the upper thoracic spine. This approach requires knowledge of the cervicothoracic regional anatomy. Surgery in this region is rare because of its indications; despite this rarity, surgeons must be prepared to expose this region. In addition, surgery in this region demands extensive opening of the surgical field and results in severe postoperative pain. Therefore, a less invasive procedure must be considered. Six cases of cervicothoracic lesion operation have been reported. The patients were successfully treated using an anterior modified approach (J-type manubriotomy). Anterior reconstruction and instrumentation of the cervicothoracic junction offers a distinct advantage of a stable anterior implant bone construction while preserving the posterior osseo-ligamentous tension band. Moreover, the modified anterior approach (J-type manubriotomy) provides the same exposure of the cervicothoracic junction without a full median sternotomy and avoids injury to subclavian vessels during resection of the clavicle or sternoclavicular junction. Therefore, the anterior cervical approach combined with J-type manubriotomy allows extensive exposure of the cervicothoracic junction and causes less complications. We performed preoperative radiological evaluation to identify the cases in which J-type manubriotomy was necessary.
机译：由于上胸椎的脊柱后凸对准，颈胸廓交界处的前侧的脊柱外科手术困难并且具有技术挑战。这种方法需要了解颈胸腔区域解剖学。由于其适应症，该地区的手术很少。尽管非常罕见，但外科医生必须做好暴露该区域的准备。此外，该区域的手术需要广泛开放手术区域，并导致严重的术后疼痛。因此，必须考虑侵入性较小的程序。据报道有6例宫颈胸腔病变手术。使用前改良方法（J型手法）成功治疗了患者。颈胸口交界处的前路重建和器械治疗提供了一个稳定的前植入物骨骼结构，同时保留了后骨韧带张紧带的独特优势。此外，改良的前入路（J型手法）可提供相同的颈胸交界处暴露，而无需进行完全正中胸骨切开术，并可避免在切除锁骨或胸锁骨交界处时锁骨下血管受损。因此，前路颈椎入路结合J型手法切开术可广泛暴露颈胸腔交界处，并减少并发症。我们进行了术前放射学评估，以确定需要进行J型手法切开术的病例。

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