Evidence map›Paper›PMID 37373799›Full record

ArticleJournal of clinical medicine2023

Anterior Access to the Cervicothoracic Junction via Partial Sternotomy: A Clinical Series Reporting on Technical Feasibility, Postoperative Morbidity, and Early Surgical Outcome.

Mohammed Issa, Jan-Oliver Neumann, Sameer Al-Maisary, Gerhard Dyckhoff, Moritz Kronlage, Karl L Kiening, Basem Ishak, Andreas W Unterberg, Moritz Scherer

Abstract read
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mohammed IssaDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.ORCID 0000-0001-7420-1647
Jan-Oliver NeumannDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Sameer Al-MaisaryDepartment of Cardiac Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Gerhard DyckhoffDepartment of Otorhinolaryngology, Heidelberg University Hospital, 69120 Heidelberg, Germany.ORCID 0000-0002-4316-4908
Moritz KronlageDepartment of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Karl L KieningDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Basem IshakDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.ORCID 0000-0002-6414-4295
Andreas W UnterbergDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Moritz SchererDepartment of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.ORCID 0000-0003-1203-9351

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Surgical access to the cervicothoracic junction (CTJ) is challenging. The aim of this study was to assess technical feasibility, early morbidity, and outcome in patients undergoing anterior access to the CTJ via partial sternotomy. Consecutive cases with CTJ pathology treated via anterior access and partial sternotomy at a single academic center from 2017 to 2022 were retrospectively reviewed. Clinical data, perioperative imaging, and outcome were assessed with regards to the aims of the study. A total of eight cases were analyzed: four (50%) bone metastases, one (12.5%) traumatic instable fracture (B3-AO-Fracture), one (12.5%) thoracic disc herniation with spinal cord compression, and two (25%) infectious pathologic fractures from tuberculosis and spondylodiscitis. The median age was 49.9 years (range: 22-74 y), with a 75% male preponderance. The median Spinal Instability Neoplastic Score (SINS) was 14.5 (IQR: 5; range: 9-16), indicating a high degree of instability in treated cases. Four cases (50%) underwent additional posterior instrumentation. All surgical procedures were performed uneventfully, with no intraoperative complications. The median length of hospital stay was 11.5 days (IQR: 9; range: 6-20), including a median of 1 day in an intensive care unit (ICU). Two cases developed postoperative dysphagia related to stretching and temporary dysfunction of the recurrent laryngeal nerve. Both cases completely recovered at 3 months follow-up. No in-hospital mortality was observed. The radiological outcome was unremarkable in all cases, with no case of implant failure. One case died due to the underlying disease during follow-up. The median follow-up was 2.6 months (IQR: 23.8; range: 1-45.7 months). Our series indicates that the anterior approach to the cervicothoracic junction and upper thoracic spine via partial sternotomy can be considered an effective option for treatment of anterior spinal pathologies, exhibiting a reasonable safety profile. Careful case selection is essential to adequately balance clinical benefits and surgical invasiveness for these procedures.

Indexed as

anterior thoracic corpectomycervicothoracic junctionpartial sternotomy

Identifiers

PMID37373799
PMCPMC10299693

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.