scholarly journals Treatment of Anterior Approach to Upper Thoracic Spine Using Total Sternum Splitting

2012 ◽  
Vol 61 (3) ◽  
pp. 513-517
Author(s):  
Shogo Tahata ◽  
Koji Akasaki ◽  
Taka-aki Sagara ◽  
Yosuke Kawatani ◽  
Hiroyuki Watanabe ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Anterior Approach ◽  
Upper Thoracic Spine ◽  
Upper Thoracic

An anterior approach to spinal pathology of the upper thoracic spine through a partial manubriotomy

2011 ◽  
Vol 15 (5) ◽  
pp. 467-471 ◽  
Author(s):  
Fred C. Lam ◽  
Michael W. Groff
Keyword(s):  
Thoracic Spine ◽  
Anterior Approach ◽  
Surgical Pathology ◽  
Anterior Decompression ◽  
Upper Thoracic Spine ◽  
Perioperative Morbidity ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Upper Thoracic

Surgical pathology in the region of the upper thoracic spine (T1–4) is uncommon compared with other regions of the spine. Often times posterior and posterolateral approaches can be used, but formal anterior decompression often requires a low anterior cervical approach combined with a sternotomy, which yields significant perioperative morbidity. The authors describe a modified low anterior cervical dissection combined with a partial manubriotomy that they have used to successfully access and decompress anterior pathology of the upper thoracic spine. Their modified approach spares the sternoclavicular joints and leaves the sternum intact, decreasing the morbidity associated with these added procedures.

A transsternoclavicular approach for the anterior decompression and fusion of the upper thoracic spine

2005 ◽  
Vol 2 (2) ◽  
pp. 226-229 ◽  
Author(s):  
Mutsuhiro Tamura ◽  
Masashi Saito ◽  
Masafumi Machida ◽  
Keiichi Shibasaki
Keyword(s):  
Thoracic Spine ◽  
Anterior Approach ◽  
Anterior Decompression ◽  
Thoracic Region ◽  
Anatomical Structures ◽  
Content Type ◽  
Upper Thoracic Spine ◽  
Upper Thoracic ◽  
Anterior Decompression And Fusion ◽  
Fine Print

✓ The anterior approach is commonly used to reach the upper thoracic region to achieve decompression and stabilization; however, upper thoracic lesions are difficult to treat because of the regional anatomical structures, and this approach is associated with risks of complication. The authors evaluated the advantages of using a transsternoclavicular approach to aid in treating upper thoracic lesions. The procedure and surgery-related outcomes are discussed.

scholarly journals Novel free-hand T1 pedicle screw method: Review of 44 consecutive cases

2014 ◽  
Vol 05 (04) ◽  
pp. 349-354 ◽  
Author(s):  
Mark A. Rivkin ◽  
Jessica F. Okun ◽  
Steven S. Yocom
Keyword(s):  
Pedicle Screw ◽  
Thoracic Spine ◽  
Pedicle Screws ◽  
High Rate ◽  
Imaging Modalities ◽  
Neurological Deficits ◽  
Upper Thoracic Spine ◽  
Starting Point ◽  
Grade 3 ◽  
Upper Thoracic

ABSTRACT Summary of Background Data: Multilevel posterior cervical instrumented fusions are becoming more prevalent in current practice. Biomechanical characteristics of the cervicothoracic junction may necessitate extending the construct to upper thoracic segments. However, fixation in upper thoracic spine can be technically demanding owing to transitional anatomy while suboptimal placement facilitates vascular and neurologic complications. Thoracic instrumentation methods include free-hand, fluoroscopic guidance, and CT-based image guidance. However, fluoroscopy of upper thoracic spine is challenging secondary to vertebral geometry and patient positioning, while image-guided systems present substantial financial commitment and are not readily available at most centers. Additionally, imaging modalities increase radiation exposure to the patient and surgeon while potentially lengthening surgical time. Materials and Methods: Retrospective review of 44 consecutive patients undergoing a cervicothoracic fusion by a single surgeon using the novel free-hand T1 pedicle screw technique between June 2009 and November 2012. A starting point medial and cephalad to classic entry as well as new trajectory were utilized. No imaging modalities were employed during screw insertion. Postoperative CT scans were obtained on day 1. Screw accuracy was independently evaluated according to the Heary classification. Results: In total, 87 pedicle screws placed were at T1. Grade 1 placement occurred in 72 (82.8%) screws, Grade 2 in 4 (4.6%) screws and Grade 3 in 9 (10.3%) screws. All Grade 2 and 3 breaches were <2 mm except one Grade 3 screw breaching 2-4 mm laterally. Only two screws (2.3%) were noted to be Grade 4, both breaching medially by less than 2 mm. No new neurological deficits or returns to operating room took place postoperatively. Conclusions: This modification of the traditional starting point and trajectory at T1 is safe and effective. It attenuates additional bone removal or imaging modalities while maintaining a high rate of successful screw placement compared to historical controls.

FLEXION-DISTRACTION INJURY OF THE UPPER THORACIC SPINE ASSOCIATED WITH TRACHEOESOPHAGEAL PERFORATION

2002 ◽  
Vol 84 (6) ◽  
pp. 1028-1031 ◽  
Author(s):  
SHIH-HAO CHEN ◽  
TSUNG-JEN HUANG ◽  
YEUNG-JEN CHEN ◽  
HUI-PING LIU ◽  
ROBERT WEN-WEI HSU
Keyword(s):  
Thoracic Spine ◽  
Upper Thoracic Spine ◽  
Upper Thoracic

scholarly journals Widespread Pressure Pain Sensitivity and Referred Pain from Trigger Points in Patients with Upper Thoracic Spine Pain

Pain Medicine ◽  
2019 ◽  
Vol 20 (7) ◽  
pp. 1379-1386 ◽  
Author(s):  
Ricardo Ortega-Santiago ◽  
Maite Maestre-Lerga ◽  
César Fernández-de-las-Peñas ◽  
Joshua A Cleland ◽  
Gustavo Plaza-Manzano
Keyword(s):  
Thoracic Spine ◽  
Pain Sensitivity ◽  
Trigger Points ◽  
Pressure Pain ◽  
Upper Thoracic Spine ◽  
Upper Trapezius ◽  
Spine Pain ◽  
Pressure Pain Thresholds ◽  
Upper Thoracic ◽  
Thoracic Spine Pain

Abstract Objectives The presence of trigger points (MTrPs) and pressure pain sensitivity has been well documented in subjects with neck and back pain; however, it has yet to be examined in people with upper thoracic spine pain. The purpose of this study was to investigate the presence of MTrPs and mechanical pain sensitivity in individuals with upper thoracic spine pain. Methods Seventeen subjects with upper thoracic spine pain and 17 pain-free controls without spine pain participated. MTrPs were examined bilaterally in the upper trapezius, rhomboid, iliocostalis thoracic, levator scapulae, infraspinatus, and anterior and middle scalene muscles. Pressure pain thresholds (PPTs) were assessed over T2, the C5-C6 zygapophyseal joint, the second metacarpal, and the tibialis anterior. Results The numbers of MTrPs between both groups were significantly different (P < 0.001) between patients and controls. The number of MTrPs for each patient with upper thoracic spine pain was 12.4 ± 2.8 (5.7 ± 4.0 active TrPs, 6.7 ± 3.4 latent TrPs). The distribution of MTrPs was significantly different between groups, and active MTrPs within the rhomboid (75%), anterior scalene (65%), and middle scalene (47%) were the most prevalent in patients with upper thoracic spine pain. A higher number of active MTrPs was associated with greater pain intensity and longer duration of pain history. Conclusions This study identified active MTrPs and widespread pain hypersensitivity in subjects with upper thoracic spine pain compared with asymptomatic people. Identifying proper treatment strategies might be able to reduce pain and improve function in individuals with upper thoracic spine pain. However, future studies are needed to examine this.

scholarly journals Anterior Decompression by Sternum Splitting Approach for Kyphosis of Upper Thoracic Spine Caused by Tuberculous Spondylitis: A Case Report

2004 ◽  
Vol 53 (2) ◽  
pp. 281-283
Author(s):  
Kazushi Nakamura ◽  
Kazunori Yone ◽  
Kyoji Hayashi ◽  
Toshihiko Izumi ◽  
Shunji Matsunaga ◽  
...  
Keyword(s):  
Case Report ◽  
Thoracic Spine ◽  
Anterior Decompression ◽  
Tuberculous Spondylitis ◽  
Upper Thoracic Spine ◽  
Upper Thoracic
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