Abstract
Mastering of surgical approaches is a basic requirement for a successful outcome of operation without damage to the vital structures. Undoubtedly, neither of these procedures are ideal as they do not meet the requirements for a physiological operation.
The chosen approach must allow for an optimal insertion of the respective implants and achievement of the required stability and at the same time eliminate traumatization of the surrounding tissues by implant long-term or permanent presence. Split of the sternum is used in spinal surgery relatively rarely.
Indication for manubriotomy/sternotomy are pathologies from C7 to T4 vertebrae and depends on the constitution of the patient. Most frequent diagnoses are fractures and tumors; both are presented in this chapter.