A Study on the Distance and Height of the Suprasternal Notch: Cervicothoracic Vertebrae in Normal Korean Adults.

Kim, Han Sik; Kim, Young Baeg; Kwon, Jeong Taik; Park, Kwan; Min, Byung Kook; Hwang, Sung Nam; Suk, Jong Sik

Original Article

Journal of Korean Neurosurgical Society 1996;25(4): 758-763.

Han Sik Kim, Young Baeg Kim, Jeong Taik Kwon, Kwan Park, Byung Kook Min, Sung Nam Hwang, Jong Sik Suk

Department of Neurosurgery, College of Medicine, Dong-A University, Pusan, Korea.

ABSTRACT

The upper thoracic vertebrae through anterior approach depends upon several variables; The diameter of the thoracic inlet, the height of the clavicles and manubrium anteriorly, and the extent of the cervicothoracic kyphosis. Preoperatively, the upper margin of the manubrium should be compaired with the vertebral body level on a standard lateral roentegenogam or mid-sagittal MRI of the upper thoracic spine. We measured the distance and the level of the corresponding vertebra of line A(horizontal line from the suprasternal notch to the corresponding vertebra) and line B(perpendicular line from the suprasternal notch to the corresponding vertebra ; thoracic inlet) on mid-sagittal MRI of normal subjects. The results were as follows: 1) In 95 cases(94 cumulative %), the line A fell to the T2 lower one third through T4 lower one third and the mean distance was 49.8+/-4.2mm(means standard deviation). 2) In 92 cases(91 cumulative %), the line B fell to the T1 lower one third to T3 middle one third and the mean distance was 45.5+/-4.9mm(means standard deviation). 3) The relation of the height and the distance with age, sex, weight, height, and body mass index were not statistically significant. We concluded that anatomical analysis of the mid-sagittal MRI of the cervicothoracic vertebrae will be helpful in selecting the access route to the cervicothoracic lesion.

Key Words: Anterior thoracic approach; Body mass index; Thoracic inlet