Surgical Planning and Neurological Outcome After Anterior Approach to Remove a Disc Herniation at the C7–T1 Level in 19 Patients

Falavigna, Asdrúbal; Righesso, Orlando; Betemps, Alejandro; Rios, Pablo Fernando Vela de los; Guimarães, Rangel; Ziegler, Marcus Sofia; Souza, Olívia Egger de; Silva, Pedro Guarise da; Riew, Daniel K.

doi:10.1097/brs.0000000000000109

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…Falavigna et al 4) recommended against the use of standalone cages alone at the C7-T1 level because of the risk of cage displacement by extrusion. They reported that 2 of 10 patients with stand-alone cages required reoperation for extrusion of the cage.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, access to C7-T1 disc herniations through the anterior aspect may be difficult because of restrictions caused by imposed obstructions by bone structures, the slope of the vertebral bodies, and the vital structures. However, reports in the literature regarding the anterior approach for C7-T1 disc herniation are few 4 8) . Thus, we report our experience with the anterior approach for the treatment of C7-T1 disc herniation, with regard to clinical presentation, limitations of operative exposure, and neurological outcome.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features of Herniated Disc at Cervicothoracic Junction Level Treated by Anterior Approach

Lee

Kim²,

et al. 2016

Korean J Spine

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ObjectiveThe anterior approach for C7-T1 disc herniation may be challenging because of obstruction by the manubrium and the narrow operative field. This study aimed to investigate the clinical and neurological outcomes of anterior approach for C7-T1 disc herniation.MethodsWe retrospectively evaluated 13 patients who underwent the anterior approach for C7-T1 disc herniation by a single surgeon within a period of 11 years (2003-2014). The minimum follow-up duration was 6 months. We describe the clinical presentation, radiographic findings, neurological outcome, and related complications.ResultsOf 372 patients with single-level anterior discectomy and fusion or artificial disc replacement for cervical disc herniation, 13 (3.5%) had C7-T1 disc herniation. The main clinical presentation was unilateral motor weakness in intrinsic hand muscles (11 patients), along with numbness, pain, and tingling sensation that radiate down the arm to the little finger. Most of the patients improved after surgery via the anterior approach. Ten patients underwent successful anterior discectomy and fusion by the standard supramanubrial Smith-Robinson approach, but 2 needed additional manubriotomy and sternotomy. In 1 patient, we performed surgery at a wrong level because the correct level was difficult to identify intraoperatively. Two patients had transient vocal dysfunction, but none had major complications related to injuries of the great vessels such as the thoracic duct or esophagus.ConclusionFor patients who require direct anterior decompression for C7-T1 disc herniation, the anterior approach is relatively feasible. However, care should be taken to overcome physical constraints by the manubrium and slope.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Features of Herniated Disc at Cervicothoracic Junction Level Treated by Anterior Approach

Lee

Kim²,

et al. 2016

Korean J Spine

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“…The total number of patients in all the included studies was 419; 234 were males (55.8%) and 185 were females (44.2%). The average age of all patients was 47 years, with the youngest mean age being 28.1 years in Dalbayrak et al 14 and the oldest mean age 63 years in Falavigna et al 19 The average follow-up time of all patients was 40 months. The summary of patients and study characteristics is shown in Table 1.…”

Section: Patients and Study Characteristicsmentioning

confidence: 94%

Outcome of Surgical Fixation to Cervicothoracic Junction: A Systematic Review of Literature

Fooz

Khattab

Maziad

2021

Egyptian Spine Journal

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Background Data: Surgical fixation of the cervicothoracic junction (CTJ) is difficult due to the complex anatomy and biomechanical properties of this area. Several important vascular, visceral, and soft tissue structures make access to this region challenging; therefore, knowledge of these structures is essential for decompression and fixation. The posterior approach is commonly used in many diseases of the spine but is inadequate when targeting the anterior spinal elements; thus, it can result in a higher complication rate and can disturb spinal stability. For these reasons, different posterolateral and anterior approaches have been developed. Study Design: Systematic review of the literature Purpose: To compare these different anterior and posterior surgical approaches to the CTJ, indicating pathologies, outcomes, and complications. Patients and Methods: This review was done using the standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. An initial search has been carried out using PubMed, Embase, Cochrane Library, Ovid, Scopus, and Google Scholar databases using the following keywords; cervicothoracic junction, C7/T4, surgical fixation; posterior approach; anterior approach. Results: Our systematic review yielded 12 studies with 419 patients that met our inclusion criteria, including seven studies using the anterior and five posterior approaches for treating different spinal pathologies. In this review, most patients with traumatic and neoplastic injuries were treated through the anterior approach, and those with degenerative and infectious diseases were treated through the posterior one. Assessment of the reported neurological status change pre-and postoperatively showed a significant difference between the anterior and posterior groups favoring the anterior one, and the rate of complications of the posterior approach was higher than that in the anterior approach. Conclusion:The data in this review may demonstrate both the effectiveness and safety of the anterior approach compared to the posterior one. These data indicate that patients who underwent the anterior approach have a higher incidence of improvement in their neurological functions and that complications in the anterior group are relatively less than those in the posterior one.

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“…Anterior cervical decompression and fusion (ACDF) is an effective treatment for many patients with pathology at C7-T1 [1] , [2] , [4] , [5] , [6] . There is little data regarding the results of cervical disc replacement (CDR) at the cervicothoracic junction.…”

Section: Introductionmentioning

confidence: 99%

Is C7-T1 cervical disc replacement a viable technique: A case series

Leonard

Song

Edwards

2022

International Journal of Surgery Case Reports

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Surgical Planning and Neurological Outcome After Anterior Approach to Remove a Disc Herniation at the C7–T1 Level in 19 Patients

Abstract: 4.

Cited by 8 publications

References 21 publications

Clinical Features of Herniated Disc at Cervicothoracic Junction Level Treated by Anterior Approach

Clinical Features of Herniated Disc at Cervicothoracic Junction Level Treated by Anterior Approach

Outcome of Surgical Fixation to Cervicothoracic Junction: A Systematic Review of Literature

Is C7-T1 cervical disc replacement a viable technique: A case series

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