The use of manubriotomy in the treatment of complicated injury of the cervicothoracic spine: clinical case report and literature review

Abstract

The paper presents a clinical case report and non-systematic review of the literature on the problem of the manubriotomy use in the treatment of complicated injury of the cervicothoracic spine. Approach to surgical treatment of complicated compression-comminuted fracture-dislocation of the cervicothoracic spine was based on preoperative calculation of angulometric characteristics of the injury and individual characteristics of the patient’s anatomy, including the Tenga criterion.  A partial resection of the manubrium of sternum in the area of the jugular notch was performed to ensure safe and stable placement of the cervical fixation plate. Complete restoration of the axis and stability of the spine, and regression of neurological deficit were achieved. The preoperative determination of the Tenga criterion in planning cervicothoracic intervention allows, taking into account the anatomical features of the patients, to assess a zone of optimal visualization, as well as to plan caudal expansion of the approach, including by limited U-shaped manubriotomy.