Transmanubrial Approach for Fracture of Lower Cervical Spine (C7) in Elderly Patients: A Case Report

Background: Fractures of the cervical spine are a frequent injury in the elderly with potentially devastating consequences. In most cases surgical therapy is required, in hyperextension fractures most often with anterior cervical fusion.Methods: We report a case of an 88-year old patient with a fracture of C7 (AO-type B3) who underwent anterior cervical fusion with manubrium sterni osteotomy for application of the caudal screws.Results: The insertion-angle of the caudal screws could be optimized; a dorsal instrumentation could be spared.Conclusion: We want to describe a technique that potentially simplifies addressing the vertebral bodies of the cervicothoracic junction for anterior cervical fusion in patients with difficult anatomical conditions and allows a safe and stable insertion of the caudal screws.Level of evidence: Level V (case report).