Anterior stabilization of the upper thoracic spine via an "interaortocaval subinnominate window": Case report and description of operative technique

Zvi R. Cohen, Daryl R. Fourney, Ziya L. Gokaslan, Garrett L. Walsh, Laurence D. Rhines

Research output: Contribution to journalArticle

Abstract

Because of the limitations imposed by the thoracic cage and the paravertebral structures, anterior access to T3 remains a challenge, particularly for the application of anterior fixation devices. Specifically, the appropriate trajectory for the correct placement of T3 screws requires significant caudal access; this may necessitate the addition of a high-level thoracotomy to the traditional combined neck exposure/sternotomy approach to the cervicothoracic junction (ie, the "trap door" exposure). The authors describe a technique for the placement of the T3 screws of a T1-T3 spinal titanium alloy plate via an "interaortocaval subinnominate window" in a patient who underwent a T2 vertebrectomy and polymethylmethacrylate reconstruction. The case history, imaging studies, illustrations, and intraoperative photographs are presented. This novel technique allows for the optimal placement of anterior fixation devices in the upper thoracic spine without the need to extend the caudal exposure with an anterolateral thoracotomy.

Original languageEnglish (US)
Pages (from-to)543-548
Number of pages6
JournalJournal of Spinal Disorders and Techniques
Volume17
Issue number6
DOIs
StatePublished - Dec 1 2004

Keywords

  • Cervicothoracic junction
  • Spinal stabilization
  • Surgical approach
  • Vertebrectomy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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