Decompressing manubriectomy under apneic oxygenation to release the median thoracic outlet compartment in bechterew disease

Individuals with long-lasting ankylosing spondylitis (AS, Bechterew disease) are at increased risk for developing fractures as the fused spine often becomes osteoporotic. These bony protuberances may compress all elements lying in front of them and induce a soft-tissue inflammation to the extent that it causes irreversible dysphagia, especially at the level of the cervical spine. We describe here the decompression of the entire visceral mass of the median thoracic aperture by a simple manubriectomy in an AS patient with refractory dyspnea and dysphagia.