International orthopaedics · 2026
A new approach to the lower cervical-thoracic spine with dislocation of the sterno-clavicular joint: FAMA (Fast Anterior Medium Approach).
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Cuzzocrea Fabrizio, Pasta Gianluigi, Monzio Compagnoni Alessandra, Berni Micaela, Annunziata Salvatore, Ghiara Matteo, Mosconi Mario, Volpato Gino
Аннотация
PURPOSE: To evaluate the Fast Anterior Medium Approach (FAMA) as an alternative to traditional anterior cervico-thoracic approaches, enhancing access to the C7-T1-T2 and T2-T4 junctions while minimizing postoperative morbidity. The cervico-thoracic junction is one of the most challenging regions to access surgically due to its deep location and proximity to critical neurovascular structures. Conventional approaches, including postero-lateral thoracotomy and transmanubrial techniques, are associated with high morbidity. The FAMA technique was designed to provide enhanced exposure while reducing surgical trauma.
METHODS: A cadaveric study was performed to understand how FAMA approach could find application in spine surgery in order to obtain wider access to the cervico-thoracic spine with lower post-operative morbidity compared to the surgical procedure with sternotomy. This approach involves controlled dislocation of the sterno-clavicular joint to extend anterior access without requiring sternotomy.
RESULTS: The approach allowed excellent exposure of the thoracic apex, enabling safe spinal stabilization procedures with minimal disruption to surrounding structures. No major neurovascular injuries occurred.
CONCLUSION: The FAMA approach represents a viable alternative to conventional cervico-thoracic surgical techniques, offering improved visualization and accessibility while preserving anatomical integrity. This technique has the potential to reduce morbidity and improve patient recovery. Larger-scale studies are required to validate these findings.
METHODS: A cadaveric study was performed to understand how FAMA approach could find application in spine surgery in order to obtain wider access to the cervico-thoracic spine with lower post-operative morbidity compared to the surgical procedure with sternotomy. This approach involves controlled dislocation of the sterno-clavicular joint to extend anterior access without requiring sternotomy.
RESULTS: The approach allowed excellent exposure of the thoracic apex, enabling safe spinal stabilization procedures with minimal disruption to surrounding structures. No major neurovascular injuries occurred.
CONCLUSION: The FAMA approach represents a viable alternative to conventional cervico-thoracic surgical techniques, offering improved visualization and accessibility while preserving anatomical integrity. This technique has the potential to reduce morbidity and improve patient recovery. Larger-scale studies are required to validate these findings.