The cervico-thoracic junction
The cervico-thoracic junction has a specific biomechanical behavior. This is due to the sudden change from the extremely flexible cervical spine, to the more rigid thoracic spine.
The thoracic spine has a shorter elastic zone due to:
- the rigid rib cage.
- the coronal orientation of the facet joints.
- the overlapping of the spinous processes.
Biomechanically the cervico thoracic junction is vulnerable to kyphosis and shear forces. Usually a long construct (2-3 levels above and 2-3 below the tumor) is necessary to achieve adequate stability. That is why the anterior alone constructs at this level are not recommended because of high-failure risks.
The anterior approaches might be difficult because of complex anatomy involving numerous essential anatomical structures at this level.