Corpectomy is an operation to remove a portion of the vertebra and adjacent intervertebral discs for decompression of the spinal cord and spinal nerves. A bone graft or an interbody cage with or without a metal plate and screws is used to reconstruct the spine and provide stability.
Indication for operation
In some patients, the thoracic or lumbar spinal canal can be narrowed by bone spurs arising from the back of the vertebral body or the ligament behind the vertebral bodies. Other causes may be tumors or spinal metastasis that are growing and putting pressure in the spinal canal from an involved vertebrae. In this situation it may be necessary to remove one or more vertebral body and the discs above and below to adequately decompress the spinal cord and/or nerve roots because the area of compression cannot be addressed by an discectomy alone. In cases of tumor or metastasis, the lesion may not be amenable to radiation or chemotherapy.
What happens afterward?
Most patients experience only mild discomfort at the operative site, which is generally well controlled with oral pain medicines. Patients may notice immediate improvement in some or all of their symptoms, however, some symptoms may improve only gradually. A successful outcome will depend on your compliance with the health care provider’s recommendations, and a realistic expectation for meeting the goals of surgery (which depend on one’s condition preoperatively).
Since cigarette smoking dramatically impairs bone healing, smoking cessation will significantly improve the likelihood for a successful fusion.
The patient is positioned on their back. For the corpectomy, an incision is made based on the necessary location.
The spine is widely exposed by separating the spaces between the normal tissues. The discs above and below the vertebrae involved are removed. The middle portion of the vertebrae is removed (some of which is saved for use in the fusion) using cutting instruments and drills to decompress the underlying spinal cord and nerve roots.
A strut of bone or interbody cage is placed to span the bony defect and provide support to the front of the spine. The bone is incorporated (fused) into the remaining vertebrae over time. Bone from the bone bank (allograft) may be substituted for the patient’s own bone. A metal plate and screws are often used to provide extra support and facilitate the fusion process.
Absorbable sutures and sometimes skin staples are used to close the incisions. A brace may or may not be required for use after surgery. The doctor will follow the fusion with periodic x-ray exams after the operation.