The following is a summary of the “Crossing the Cervicothoracic Junction” published in the December 2022 issue of Clinical Spine Surgery by Vickery et al.

The cervicothoracic junction is a region of the spine that, in comparison to other sections of the spine, exhibits a unique set of obstacles that must be overcome during surgical procedures. This spine section is also known as the cervicothoracic junction (CTJ). Alterations in the region’s biomechanical qualities, osseous architecture, and spinal alignment all contribute to the problems that are particular to this site of the spine when it comes to surgical instrumentation.

When a construct approaches or actually crosses the CTJ, surgical decision-making is currently being driven by an ever-expanding body of information. This is the case whether the construct is in the vicinity of or crosses the CTJ. On the other hand, there is a growing body of information that can support surgical decision-making in regard to the CTJ at this time. Using anecdotal information to influence decision-making in relation to instrumentation either near or across the CTJ was common practice until quite recently. 

This article will discuss the benefits and drawbacks of instrumenting the CTJ as a whole, as well as provide an analysis of the most common instrumentation designs and the clinical indications for implementing them. Additionally, the article will discuss the clinical indications for implementing these designs. In addition to this, researchers will also provide a discussion of the particular anatomical and biomechanical aspects of the CTJ in their article.