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Cervicothoracic junction instrumentation: Single center retrospective clinical analysis

Mehmet Sorar, Omer Selcuk Sahin.




Abstract
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Aim: The surgery of lesions involving the cervicothoracic junction was one of the challenging problems in spinal surgery practice. This area is quite unusual, especially since it is a transition zone from hard and relatively stationary thoracic and lumbar vertebrae to the kyphotic and movable cervicothoracic vertebrae. The fact that the cervicothoracic junction differs from the other vertebrae anatomy forces the surgeons to push into more conservative approaches. The instability of this component may cause fatal clinical results and may be necessary to stabilize due to tumor, trauma, infection, or degeneration. Material and Methods: In this study, we examined 24 patients who underwent cervicothoracic region in our clinic between 2012 and 2017 retrospectively, and their age, gender, pathologies that cause medical need, instability of the vertebrae, howmany vertebrae were included in the pathology, surgical methods and results were evaluated.Results: According to Frankel scores, neurological examination improved in 4 cases (17%) in the early postoperative period and worsening in 1 patient (4%). In the other 19 patients (79%), Frankel scores were not different in the preoperative and early postoperative examination.Conclusion: Neurosurgeons should treat the instability of this region discreetly, and they should keep in mind that the surgical procedures involving this area may affect the stability of this region iatrogenically. In patients with cervicothoracic junctional pathologies, motor and sensory loss may occur below the relevant segment, and functional rehabilitation of these patients may be possible with early diagnosis, surgery, and post-rehabilitation applications.

Key words: Cervicothoracic Junction; Instrumentation; Instability.






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