Transclavicular Transmanubrial Approach to the Cervico-Thoracic Junction

Transclavicular Transmanubrial Approach to the Cervico- Thoracic Junction

The cervicothoracic junction (CTJ) is a difficult region to approach for the spinal surgeon due to the critical structures surrounding this area. Although the traditional posterior approaches are easier and instrumentation possible, decompression of anterior pathologies and subsequent stabilization is suboptimal by this route. Anterior approaches are narrow and deep and between the critical structures. We describe the transclavicular transmanubrial approach to the CTJ in this series. Combining manubriotomy and medial portion of clavicle excision expands the exposure and permits anterior decompression and stabilization of the CTJ.