Anterior Cervical Incision and Thoracotomy for Cervicothoracic, Thoracic, and Thoracolumbar Spine Surgery: A Clinical Series

Introduction: Surgical treatment of diseases in cervicothoracic, thoracic and thoracolumbar regions can be a challenging issue. Cooperation of the thoracic surgeons and spine surgeons can improve the outcomes and decrease the complications of patients who underwent these approaches. Materials and Methods: The participants of this study consisted of seventeen patients suffering from different types of vertebral lesions such as spinal tuberculosis (TB), primary tumor, metastasis, and scoliosis. These patients were operated through anterior lower cervical incision (without sternotomy), standard thoracotomy, and lower thoracotomy during 2001-2016. For five patients, exposure of cervicothoracic region was achieved through anterior cervical incision with extension to anterior chest wall (without sternotomy). Through performing posterolateral thoracotomy (left or right) on nine patients, spine surgeons had a better access to the vertebral pathologies. In three cases, a perfect access to the thoracoabdominal spine was obtained by performing lower thoracotomy with removal of the twelfth rib and release of diaphragm from the chest wall. Results: In total, seventeen patients [eleven males (65%) and 6 (35%) females] with the mean age of 33.6 ± 19.4 were operated. six (35%) patients suffered from cervicothoracic lesions, 8 (47%) cases had lesions in middle and lower thoracic spine, and 3 (18%) patients had lesion in the thoracolumbar vertebra. Postoperatively, no mortality was observed in the patients and complications were reported to be minimal. Conclusion: According to the findings, the joint corporation of thoracic and spine surgeons can improve exposure of cervicothoracic, thoracic, and thoracolumbar regions. Furthermore, this approach can decrease the complications of these complex surgeries.