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How I do it: tapered rod placement across the cervicothoracic junction for augmented posterior constructs

  • How I Do it - Neurosurgical technique evaluation
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Abstract

Background

Posterior instrumentation techniques are commonly employed for cervicothoracic fixation. The pedicles of the upper thoracic vertebrae can typically accommodate larger diameter screws than the subaxial cervical vertebrae. In many construct systems, this requires the use of a tapered rod, which can be technically challenging to place.

Method

Using a three-dimensionally printed biomimetic spine simulator, we illustrate the stepwise process of instrumentation and tapered rod placement across the cervicothoracic junction (CTJ).

Conclusion

Tapered rod systems can augment the biomechanical stability of cervicothoracic constructs. Ease of rod placement across the CTJ hinges upon a systematic method of instrumentation.

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References

  1. Barrey C, Cotton F, Jund J, Mertens P, Perrin G (2003) Transpedicular screwing of the seventh cervical vertebra: anatomical considerations and surgical technique. Surg Radiol Anat 25:354–360. https://doi.org/10.1007/s00276-003-0163-5

    Article  CAS  PubMed  Google Scholar 

  2. Bayoumi AB, Efe IE, Berk S, Kasper EM, Toktas ZO, Konya D (2018) Posterior rigid instrumentation of C7: surgical considerations and biomechanics at the cervicothoracic junction. A Review of the Literature. World Neurosurg 111:216–226. https://doi.org/10.1016/j.wneu.2017.12.026

    Article  PubMed  Google Scholar 

  3. Clifton W, Edwards S, Louie C, Dove C, Damon A, Nottmeier E, Pichelmann M (2019) Techniques and tips for freehand placement of C7 pedicle screws with respect to cervicothoracic constructs: 2-dimensional operative video. Oper Neurosurg. https://doi.org/10.1093/ons/opz235

  4. Godzik J, Dalton JF, Martinez-Del-Campo E, Newcomb A, Dominguez F, Reyes PM, Theodore N, Kelly BP, Crawford NR (2018) Biomechanical evaluation of cervicothoracic junction fusion constructs. World neurosurgery. https://doi.org/10.1016/j.wneu.2018.12.040

    Article  Google Scholar 

  5. Heller JG, Carlson GD, Abitbol JJ, Garfin SR (1991) Anatomic comparison of the Roy-Camille and Magerl techniques for screw placement in the lower cervical spine. Spine 16:S552–S557. https://doi.org/10.1097/00007632-199110001-00020

    Article  CAS  PubMed  Google Scholar 

  6. Kulkarni AG, Dhruv AN, Bassi AJ (2015) Posterior cervicothoracic instrumentation: testing the clinical efficacy of tapered rods (dual-diameter rods). J Spinal Disord Tech 28:382–388. https://doi.org/10.1097/bsd.0000000000000133

    Article  PubMed  Google Scholar 

  7. Radcliff KE, Koyonos L, Clyde C, Sidhu GS, Fickes M, Hilibrand AS, Albert TJ, Vaccaro AR, Rihn JA (2013) What is the incidence of dysphagia after posterior cervical surgery? Spine 38:1082–1088. https://doi.org/10.1097/BRS.0b013e318287ec9f

    Article  PubMed  Google Scholar 

  8. Wang VY, Chou D (2007) The cervicothoracic junction. Neurosurg Clin N Am 18:365–371. https://doi.org/10.1016/j.nec.2007.02.012

    Article  PubMed  Google Scholar 

  9. Yu CC, Bajwa NS, Toy JO, Ahn UM, Ahn NU (2014) Pedicle morphometry of upper thoracic vertebrae: an anatomic study of 503 cadaveric specimens. Spine 39:E1201–E1209. https://doi.org/10.1097/brs.0000000000000505

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurological Surgery, Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA

    William Clifton & Mark Pichelmann

  2. Department of Education, Mayo Clinic Florida, Jacksonville, FL, USA

    Aaron Damon

Authors
  1. William Clifton
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  2. Aaron Damon
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  3. Mark Pichelmann
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Corresponding author

Correspondence to William Clifton.

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This article is part of the Topical Collection on Neurosurgical technique evaluation

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Video 1

Preoperative considerations, vital anatomy, and operative technique of tapered rod system for enhancing the biomechanical stability of cervicothoracic constructs. This is demonstrated using a 3D-printed biomimetic simulator (M4V 122553 kb)

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Clifton, W., Damon, A. & Pichelmann, M. How I do it: tapered rod placement across the cervicothoracic junction for augmented posterior constructs. Acta Neurochir 161, 2429–2431 (2019). https://doi.org/10.1007/s00701-019-04081-2

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  • DOI: https://doi.org/10.1007/s00701-019-04081-2

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