Surgical challenges in posterior cervicothoracic junction instrumentation

The cervicothoracic junction (CTJ) is a region of the spine submitted to significant mechanical stress. peculiar anatomical and biomechanical characteristics make posterior surgical stabilization this area particularly challenging. We present discuss our series highlighting specific challenges provided by spine. have analyzed reported retrospective data from patients who underwent instrumentation between 2011 2019 at Neurosurgical Department Geneva University Hospitals. discussed C7 Th1 techniques, rods design, extension constructs, spinal navigation. Thirty-six were enrolled. preferentially used lateral mass (LM) screws in subaxial pedicle (PS) C7, Th1, upper thoracic found no superiority 3D navigation techniques over 2D fluoroscopy guidance PS placement accuracy, probably due relatively small case series. Surgical site infection was most frequent complication, significantly associated with tumor as diagnosis. When technically feasible, represent technique choice for although other safe are available. Different rod constructs described differences stability still need be clarified. Spinal should whenever available even though option. Posterior CTJ challenging procedure, but correct planning technique, it effective.