The authors present their experience in the operative treatment of
unstable lesions at the cervicothoracic junction. Ten patients, six men
and four women, underwent operative procedures at the cervicothoracic
junction (C7-T1) between 1990 and 1997. Six patients had sustained
fracture-dislocations, three patients had metatases and one patient had
a primary malignant lesion. All the patients had significant cervical
pain and neurologic deficit. The spinal cord and nerves were
decompressed in all cases. Posterior stabilization was accomplished
using various types of implants including hooks, wires and rods.
Anteriorly, the spine was stabilized with plates and screws. Partial or
complete vertebrectomy was performed in five cases and a titanium
cylinder or an iliac autograft replaced the vertebral body. Five
patients were submitted to a posterior operation only, and the other
five to bilateral procedures. In four of these a one-stage operation was
performed and in the last case a two-stage procedure. The anatomic and
biomechanical characteristics of the cervicothoracic junction require a
precise pre-operative analysis of the local anatomy and the selection of
the proper implants for anterior and posterior stabilization