A corpectomy is a surgical procedure in which vertebral bone and intervertebral disc material is removed to relieve pressure on the spinal cord and spinal nerves (decompression). It can be performed in the Cervical (neck) and Lumbar (lower back) regions of the spine. Often corpectomy surgery is done in conjunction with a Spinal fusion. The spinal fusion is usually necessary to provide stability to the spine because of the amount of vertebral bone and/or disc material that must be removed to achieve sufficient decompression during the corpectomy.
Spinal fusion involves placing a bone graft substitute between two or more affected vertebrae to promote bone growth between the vertebral bodies. The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.
Cause
Nerve compression in the cervical vertebra can cause neck pain and/or pain, numbness and weakness that extends into the shoulders, arms and hands. Similarly nerve compression on the lower back can cause back pain and/or pain, numbness and weakness that extends into the hips, buttocks and legs. Both may be caused by:
- Degenerative spinal conditions (herniated discs and bone spurs)
- Spinal fracture
- Tumor
- Infection
To determine whether your condition requires surgical treatment your neurosurgeon will complete a physical assessment, take your medical history, and may order an x-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of your cervical vertebrae.
Types of Corpectomy
If surgery is determined the best treatment for you, your neurosurgeon will then assess the best approach to use to give your individual condition the best possible treatment.
An Anterior Cervical Corpectomy and fusion is a surgical procedure in which vertebral bone and intervertebral disc material is removed to relieve pressure on the spinal cord and spinal nerves (decompression) in the cervical spine, or neck. The procedure typically involves accessing the cervical spine through an anterior approach, or from the front.
An anterior cervical corpectomy and fusion is typically recommended only after conservative treatment methods fail. Through an incision either to the right or left of the midline of your neck, your surgeon will:
- Gently retract the muscles and tissues of the neck to expose the anterior vertebral column.
- Remove a portion of the vertebral body(ies) and intervertebral disc(s) to access the compressed neural structures
- Relieve the pressure by removing the source of the compression
- Place a bone graft or bone graft substitute between the adjacent vertebrae at the decompression site
- Attach instrumentation, such as plating and screws, along the treated vertebra(e) to provide extra support and stability while fusion and healing occurs.
Your surgeon will have a specific postoperative recovery plan to help you return to your normal activity level as soon as possible. Following an anterior cervical corpectomy and fusion, you may notice an immediate improvement of some or all of your symptoms; other symptoms may improve more gradually. The amount of time that you have to stay in the hospital will depend on your treatment plan. How quickly you return to work and your normal activities will depend on how well your body heals and the type of work/activity level you plan to return to.
Work closely with your spinal surgeon to determine the appropriate recovery protocol for you, and follow his or her instructions to optimize the healing process.
An Anterior Lumbar Corpectomy and fusion is a surgical procedure in which vertebral bone and intervertebral disc material is removed to relieve pressure on the spinal cord and spinal nerves (decompression) in the lumbar spine, or lower back. The procedure typically involves accessing the spine through an anterolateral (flank or side of the body incision through the abdominal region) approach. Spinal fusion is usually necessary because of the amount of vertebral bone and disc material that must be removed to achieve sufficient decompression of the neural structures.
Through an incision made in the side of your abdomen, your surgeon will:
- Remove a portion of the vertebral body(ies) and intervertebral disc(s) to access the compressed neural structures
- Relieve the pressure by removing the source of the compression
- Place a bone graft or bone graft substitute between the adjacent vertebrae at the decompression site
- Attach/implant instrumentation – rods, plates and screws – along the treated vertebra(e) to provide extra support and stability while fusion and healing occurs.
Patients with a severe spinal problem or instability may also require a posterior spinal fusion with instrumentation in addition to an anterior corpectomy and fusion. If necessary, the second surgery is typically performed in a staged fashion several days after the initial corpectomy/fusion procedure.
Anterior corpectomy and fusion also can be performed in the thoracic (chest) region or thoracolumbar (lower chest/mid-back) region, depending on where the neurologic compression is located.
Work closely with your neurosurgeon to determine the appropriate treatment and recovery protocol for you, and follow his or her instructions to optimize the healing process.
