Applied anatomy of the anterior approach to 2nd and 3rd thoracic vertebral bodies with osteotomy of the clavicle and partial median sternotomy
DUAN Hong, LIU Zong-Liang, MIN Cha, HE Yun, LI Xin-Guo
Chinese Journal of Clinical Anatomy ›› 2012, Vol. 30 ›› Issue (1) : 12-16.
Applied anatomy of the anterior approach to 2nd and 3rd thoracic vertebral bodies with osteotomy of the clavicle and partial median sternotomy
Objective To explore an ideal method of exposing and treating 2nd and 3rd thoracic vertebral bodies. Methods 30 adult embalmed cadavers (50 sides) were selected and observed. By modeling the anterior approach, the 2nd and 3rd thoracic vertebral bodies were exposed and treated through dissecting a safe space among superior edge of the aortic arch, left subclavian artery, left common carotid, brachiocephalic trunk and brachiocephalic veins. Results Under the standard left anterior approach combined with osteotomy of the clavicle and partial median sternotomy, through the synostosis between the manubrium and body of the sternum, a safe space can be acquired: left carotid sheath (common carotid, internal jugular vein, vagus nerve and its branches), thoracic duct, truncus sympathicus cervicalis, and left pleura mediastinalis were pulled towards lateral; trachea, esophagus, and left recurrent laryngeal nerve were pulled towards internal; left brachiocephalic vein was pulled towards inferior. T1-T3 can be easily exposed on the total 30 adult human cadavers and T4 also can be observed on partial cases. Conclusions Adequate exposure of 2nd and 3rd thoracic vertibral bodies can be obtained by the above approach. It provides adequate work room for treating them.
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