Aberrant left brachiocephalic vein is a contraindication for anterior cervicothoracic approach

Ong, Edwin Kean Siong and Wong, Tat Seng and Chung, Weng Hong and Chiu, Chee Kidd and Saw, Aik and Hasan, Mohd Shahnaz and Chan, Chris Yin Wei and Kwan, Mun Keong (2019) Aberrant left brachiocephalic vein is a contraindication for anterior cervicothoracic approach. Journal of Orthopaedic Surgery, 27 (3). p. 230949901987921. ISSN 2309-4990, DOI https://doi.org/10.1177/2309499019879213.

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Official URL: https://doi.org/10.1177/2309499019879213


Aberrant left brachiocephalic vein is a rare condition. Its occurrence in patients requiring anterior cervicothoracic approach for severe kyphoscoliosis has not been described. A 16-year-old male with neurofibromatosis and severe upper thoracic kyphoscoliosis presented to us with curve progression. Halo gravity traction was attempted but failed to achieve significant correction. Subsequently, he underwent halo-pelvic traction and later Posterior Spinal Fusion (PSF) from C2 to T10. Second-stage anterior cervicothoracic approach with anterior fibula strut grafting was planned; however, preoperative computed tomography angiography revealed an aberrant left brachiocephalic vein with an anomalous retrotracheal and retroesophageal course, directly anterior to the T5/T6 vertebrae (planned anchor site for fibula strut graft) before draining into superior vena cava. Therefore, surgery was abandoned due to the risks associated with this anomaly. Aberrant left brachiocephalic vein is rare, the presence of which could be a contraindication for anterior cervicothoracic approach. Assessment of the anterior neurovascular structures is crucial in preoperative planning. © The Author(s) 2019.

Item Type: Article
Uncontrolled Keywords: aberrant brachiocephalic vein; anterior cervicothoracic approach; computed tomography; fibular strut graft; kyphoscoliosis; neurofibromatosis; retroesophageal; retrotracheal
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 14 Feb 2020 03:27
Last Modified: 14 Feb 2020 03:27
URI: http://eprints.um.edu.my/id/eprint/23801

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