Full median sternotomy approach for treatment of upper thoracic vertebral tuberculosis in a developing country: case report and short literature review

Isaac Okyere; Anthony Lamina; Benedict Owusu

doi:10.11604/pamj.2017.28.112.12948

Full median sternotomy approach for treatment of upper thoracic vertebral tuberculosis in a developing country: case report and short literature review

Pan Afr Med J. 2017 Oct 5:28:112. doi: 10.11604/pamj.2017.28.112.12948. eCollection 2017.

Authors

Isaac Okyere¹, Anthony Lamina², Benedict Owusu²

Affiliations

¹ Cardiothoracic and Vascular Surgeon, Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital,Kumasi, Ghana.
² Neurosurgeons, Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Abstract

Direct anterior approach to the cervicothoracic spine (C7-T4) poses a technical challenge in neurosurgery, due to the presence of important neurovascular structures anterior to the cervicothoracic junction (CTJ). Median Sternotomy approach is a surgical option that allows for direct anterior exposure of the lower cervical and upper thoracic vertebrae. We report the first case from Ghana, West Africa of a young man who developed post-tuberculosis osteomyelitis of upper thoracic (T1-2) vertebrae with cord compression after spinal tuberculosis in childhood. He underwent a full median Sternotomy for Anterior Decompression and Fusion of C7-T2 with autologous iliac crest bone graft. We detail our operative procedure and review the relevant literature.

Keywords: Osteomyelitis; cervicothoracic junction; laminectomy; median Sternotomy.

Publication types

Case Reports
Review

MeSH terms

Ghana
Humans
Male
Osteomyelitis / surgery*
Spinal Cord Compression
Spinal Fusion
Sternotomy / methods*
Thoracic Vertebrae
Tuberculosis, Spinal / surgery*
Young Adult