Evaluation of Results of Anterior Cervicothoracic Junction Decompression & Fusion (ACTJDF) of C7-T1-T2 Spinal Tuberculosis by Transmanubrial Transclavicular Approach.
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Date
2020-03
Journal Title
Journal ISSN
Volume Title
Publisher
Akshantala Enterprises Private Limited
Abstract
Spinal tuberculosis is the most frequently encountered & destructive form of skeletal tuberculosis. We wanted to evaluate the advantages of transmanubrial transclavicular approach in the surgical management of the pathologies (mainly tuberculosis) at the cervicothoracic junction (C7,T1-2).METHODSFrom June 2013 to August 2019, thirty patients with tuberculosis of CTJ presented to SCBMC & H and were operated with transmanubrial transclavicular approach. Debridement with corpectomy of tuberculosis of C7-T1 and T1 vertebral bodies were followed by fusion of C6-T2 and C7-T2 vertebra respectively with the help of titanium mesh cage and anterior cervical plating. Advantages & limitations of this surgical approach were evaluated retrospectively. Visual analogue scoring & Frankel scoring were used for assessing postoperative clinical outcome.RESULTSAll 30 cases were of tuberculosis of CTJ involving either C7-T1 or T1-T2. They presented with a permutation combination of upper thoracic pain, paraparesis, and collapse of vertebra & cord compression. All patients were followed up for 12.37 ± 5.38 months on average (range 4 -24 m). The mean postoperative visual analogue scale score was 7.86 ± 1.02 (range 6-10) preoperatively, which improved to 3.27 ± 0.88 (range 0-5) postoperatively at final evaluation (p<0.005). There was also postoperative increase in Frankel score in seventeen cases (56%). Three patients developed temporary hoarseness postoperatively, two cases got infected (one superficial & one deep) & one patient died. There was no non-union or persistent pain at manubrium or clavicle end.CONCLUSIONSThe transmanubrial transclavicular approach for tuberculosis of CTJ lesions can achieve favourable clinical outcomes by providing wide exposure, direct decompression of lesions, fusions and less complications as compared to standard approaches.
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Keywords
CTJ (Cervico-Thoracic Junction), Tuberculosis, Corpectomy
Citation
Mohanty Atanu, Biswas Rupak, Mohanty Anuraag. Evaluation of Results of Anterior Cervicothoracic Junction Decompression & Fusion (ACTJDF) of C7-T1-T2 Spinal Tuberculosis by Transmanubrial Transclavicular Approach.. Journal of Evolution of Medical and Dental Sciences. 2020 Mar; 9(12): 905-908