versão impressa ISSN 1808-1851
HERRERO, Carlos Fernando Pereira da Silva; PENNO, Ricardo Alberto Lupinacci e DEFINO, Helton LA. Surgical treatment of the cervicothoracic junction diseases. Coluna/Columna [online]. 2009, vol.8, n.1, pp. 19-26. ISSN 1808-1851. http://dx.doi.org/10.1590/S1808-18512009000100005.
OBJECTIVE: to assess the results of the surgical treatment of patients with disease in the cervicothoracic junction of the spine. METHODS: twenty patients were retrospectively evaluated. Nine patients (45%) had traumatic lesions, seven (35%) neoplasic lesions and four (20%) degenerative arthropathies. In the group of patients with traumatic lesions it has been accomplished the posterior fixation in five patients (55.5%), anterior fixation in one patient (11.1%) and the combined approach (anterior and posterior) in three patients (33.3%). In the seven patients with neoplasic lesions, four (57.1%) underwent to the surgical treatment through the combined approach and 3 (42.8%) through the posterior approach. In the group of patients with spinal degenerative disease, three (75%) were treated through the posterior approach and one (25%) in a combined way. The patients were evaluated on the basis of clinical (pain and neurological deficit), radiological (reduction maintenance and implant loosening or break) and functional parameters (SF-36, Denis scale of work and pain). RESULTS: twenty patients were followed-up for a period of time ranging from six months to 11 years (44.6 months ± 29.02). From 13 patients which presented neurological deficit, eight patients presented improvement in Frankel scale level (61.5%) and five patients (38.5%) remained with the same level. As complications, one patient (5%) presented implant loosening and four patients presented postoperative infection (20%). In pain and work assessment, 80% of the patients presented few or no pain (P1 and P2) through Denis scale of pain, and 70% of the patients had returned to work (W1, W2 and W3) through Denis scale of work. The patients without neurological deficit (Frankel E) presented higher scores of life quality through the SF-36 questionnaire compared to the patients who had neurological deficit (Frankel A-D). CONCLUSION: the treatment of the diseases of the cervicothoracic junction of the spine presents additional details compared to the others segments of the spine. The surgical treatment has aspects to be respected as the anatomy related to the surgical access, the peculiar anatomic characteristics of the vertebrae and the unique biomechanics of this spinal segment.
Palavras-chave : Spinal diseases [surgery]; Questionnaires; Spinal injuries; Cervical vertebrae [injuries]; Cervical vertebrae [surgery]; Thoracic vertebrae [surgery].