Traumatic Injuries at the Cervicothoracic Junction
Journal
Clinical Spine Surgery
ISSN
2380-0186
Date Issued
2025-11-20
Author(s)
Guillermo Ricciardi
Guisela Quinteros
Ignacio Cirillo
Juan P. Cabrera
Edgar Marquez García
Charles Carazzo
Alfredo Guiroy
Type
journal-article
Abstract
<jats:sec>
<jats:title>Study Design:</jats:title>
<jats:p>Multicenter retrospective cohort study.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Objective:</jats:title>
<jats:p>To analyze a multicenter cohort of patients who underwent surgical treatment for C7–T1 traumatic injuries, focusing on their surgical approach and complications.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Summary of Background Data:</jats:title>
<jats:p>C7–T1 injuries are rare and biomechanically complex, with limited evidence guiding optimal surgical management.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>A retrospective analysis of patients with surgically treated C7–T1 traumatic injuries from 13 Latin American Institutions (2014–2023) was conducted. Demographic and clinical data was collected, with a focus on morbidity and complications.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
Among a multicenter database of 545 unstable cervical fractures, 55 (10%) involved the C7–T1 segment. Patients were predominantly male (n=41; 73.2%), with a mean age of 43.2 years (SD). Falls (n=28; 50%) and traffic accidents (n=20; 35.7%) were the leading causes. Neurological deficit was the rule (63.6%). Surgical approaches included single-posterior (44.6%), single-anterior (30.4%), and combined (23.2%). Surgery was performed within 24 hours in 33.9% of cases. Early complications occurred in 17.9%, with pneumonia and surgical site infections being the most common. Complications correlated with longer hospital stays (
<jats:italic toggle="yes">P</jats:italic>
=0.029) and associated injuries (
<jats:italic toggle="yes">P</jats:italic>
=0.028) but not with surgical delay (
<jats:italic toggle="yes">P</jats:italic>
=0.256) or approach (
<jats:italic toggle="yes">P</jats:italic>
=0.380).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions:</jats:title>
<jats:p>C7–T1 injuries are challenging to manage, with posterior approaches most frequently used and anterior-only techniques reserved for fractures without translation. Early complications were common and prolonged hospitalization. Their occurrence appeared to be independent of the surgical approach used.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Level of evidence:</jats:title>
<jats:p>Level III.</jats:p>
</jats:sec>
<jats:title>Study Design:</jats:title>
<jats:p>Multicenter retrospective cohort study.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Objective:</jats:title>
<jats:p>To analyze a multicenter cohort of patients who underwent surgical treatment for C7–T1 traumatic injuries, focusing on their surgical approach and complications.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Summary of Background Data:</jats:title>
<jats:p>C7–T1 injuries are rare and biomechanically complex, with limited evidence guiding optimal surgical management.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>A retrospective analysis of patients with surgically treated C7–T1 traumatic injuries from 13 Latin American Institutions (2014–2023) was conducted. Demographic and clinical data was collected, with a focus on morbidity and complications.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
Among a multicenter database of 545 unstable cervical fractures, 55 (10%) involved the C7–T1 segment. Patients were predominantly male (n=41; 73.2%), with a mean age of 43.2 years (SD). Falls (n=28; 50%) and traffic accidents (n=20; 35.7%) were the leading causes. Neurological deficit was the rule (63.6%). Surgical approaches included single-posterior (44.6%), single-anterior (30.4%), and combined (23.2%). Surgery was performed within 24 hours in 33.9% of cases. Early complications occurred in 17.9%, with pneumonia and surgical site infections being the most common. Complications correlated with longer hospital stays (
<jats:italic toggle="yes">P</jats:italic>
=0.029) and associated injuries (
<jats:italic toggle="yes">P</jats:italic>
=0.028) but not with surgical delay (
<jats:italic toggle="yes">P</jats:italic>
=0.256) or approach (
<jats:italic toggle="yes">P</jats:italic>
=0.380).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions:</jats:title>
<jats:p>C7–T1 injuries are challenging to manage, with posterior approaches most frequently used and anterior-only techniques reserved for fractures without translation. Early complications were common and prolonged hospitalization. Their occurrence appeared to be independent of the surgical approach used.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Level of evidence:</jats:title>
<jats:p>Level III.</jats:p>
</jats:sec>