From August 1999 to February 2006, 11 patients with cervicothoracic lesions (eight males, three females; age range, 17–77 years)
were surgically treated using the trans-upper-sternal approach. Combined cervicothoracic incision and upper sternotomy facilitated
exposure for tumor resection, partial or subtotal removal of the involved vertebrae, and spinal cord decompression. The spinal
column then was stabilized. Neurologic status was assessed using the Frankel classification. Followup for a minimum of 10 months
(mean, 31 months; range, 10–56 months) revealed one patient had a chyle leak (50 mL) 1 day after surgery, which resolved after
2 days of drainage. One patient had a transient vocal cord paresis, which recovered within 3 months of surgery. All the patients
had improved neurologic function. No nonunions or instrument-related complications developed. Stability of the vertebral column
was maintained during followup in all patients. The trans-upper-sternal approach can provide excellent exposure for reconstruction
of the cervicothoracic junction. Special care must be taken to avoid injury to the recurrent laryngeal nerve and the thoracic
duct.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were
conducted in conformity with ethical principles of research, and that informed consent for participating in the study was
obtained.