Anterior stabilization of severe structural deformities of the spine,
especially kyphoscoliosis, at the cervicothoracic level is a difficult
surgical procedure. A new combined procedure including anterolateral
cervical and posterior transpleural transthoracic approaches to the
cervicothoracic spine provided adequate-exposure from the third cervical to
the ninth thoracic vertebra and at the same time gave access to the great
vessels in the event that control of these became necessary. The procedure
has been employed in six patients with severe cervicothoracic
kyphoscoliosis. Despite the magnitude of the combined cervical and
transthoracic exposure, the patients withstood the procedure well and there
were no complications. The fusion was successful in all six patients. The
kyphotic deformities were corrected by an average of 26 degrees and the
scoliotic curves, by an average of 17 degrees.