Surgical Treatment of Metastatic Lesions at the Cervicothoracic Spinal Junction

Abstract

Background Data: Metastatic spine disease continues to be an increasing burden. The cervicothoracic junction represents a transition from the semi rigid thoracic spine to the mobile sub axial cervical spine. Pathologic lesions are prone to result in kyphotic deformity as well as to the possibility of neurological deficits.Purpose: The aim of this study is to review our experience with surgical stabilization of metastatic lesions affecting the cervicothoracic junction (C7-T2).Study Design: A descriptive analytic cross section retrospective study involving 12 patients.Patients and Methods: The authors retrospectively reviewed their archive between February 2011 and July 2016, and twelve patients who were operated upon due to cervicothoracic junction metastasis were included. All patients underwent surgical treatment by either anterior corpectomy and fixation or posterior decompression and stabilization utilizing tapered rods. The patients were periodically followed up.Results: A total of twelve patients were included in this study including six males and six females. They had their primary in the breast in five patients, in the lung in three patients, in the prostate in two patients, and fro adenocarcinoma in two patients. The anterior approach was used in nine patients while the posterior approach was used in three patients. There was clinical improvement in neurological status according to Frankel grades of paraplegia in eleven of the twelve patients. There was no loss of correction in any patient of the study group.Conclusion: Patients with cervicothoracic metastatic lesions can be treated with either anterior or posterior approaches after considering each individual’s potential instability and disease burden. (2017ESJ135)