The efficacy of 5.5-mm diameter rods combined with cervical pedicle screws for the treatment of challenging spinal disease in cervicothoracic junction: Is it a game-changer?

The cervicothoracic junction (CTJ) presents a surgical challenge due to its transitional nature from mobile to rigid segments. Therefore, the biomechanical characteristics of this transitional zone must be taken into consideration during instrumentation. This study aimed to determine the efficacy of the cervical pedicle screw placement (CPS) combined with 5.5-mm single-diameter rods in treating various challenging diseases at the CTJ. From March 2018 to February 2022, a total of 42 patients (male = 25; female = 17) underwent posterior cervical spinal surgery crossing the CTJ with or without an anterior approach by a single surgeon. The mean patient age was 58.6 years (range, 16-81 years). In all the included cohorts, only the Legacy® pedicle screw system (Medtronic Sofamor Danek, Inc., Memphis, TN, USA) was used for the placement of pedicle screws on the cervical and thoracic vertebrae at the CTJ. This study describes the detailed indications and results of the treatment for 5 disease categories. CPS combined with 5.5-mm single-diameter rods provides biomechanical stability for the treatment of challenging conditions, such as trauma, benign or malignant tumors, or deformities in the CTJ.