A corpectomy is a surgical procedure performed on the spine. It involves removing a portion of a vertebral bone to alleviate pressure on the spinal cord or surrounding nerves. This surgery addresses various conditions affecting the spinal column.
What is a Corpectomy
A corpectomy involves the surgical removal of all or part of a vertebral body, which is the large, cylindrical bone segment forming the front part of a vertebra. This removal is performed to decompress, or relieve pressure from, the spinal cord or nerve roots that may be compressed by bone spurs, tumors, disc material, or fractured bone fragments. The vertebral body is a weight-bearing structure of the spinal column, and its removal creates a space for the affected neural elements to function without impingement.
The human spine is composed of individual bones called vertebrae, stacked upon one another and separated by intervertebral discs. During a corpectomy, the surgeon carefully removes the problematic vertebral body and the adjacent intervertebral discs above and below it.
Following the removal of the vertebral body, the spine’s stability is compromised, necessitating a reconstructive step. This involves placing a bone graft or a specialized cage made of metal or synthetic material into the newly created space. This graft or cage acts as a spacer, restoring the height between the vertebrae and providing immediate support. To ensure long-term stability and promote fusion, metal plates and screws are affixed to the vertebrae above and below the graft, immobilizing the segment and allowing the bones to grow together over time.
Reasons for Corpectomy
Corpectomy is considered when severe compression of the spinal cord or nerve roots cannot be adequately addressed by less extensive procedures. One reason for this surgery is severe spinal stenosis, a narrowing of the spinal canal that can exert pressure on the neural structures. This narrowing might be caused by degenerative changes like bone spurs or thickened ligaments.
Tumors originating in or spreading to the vertebral body can also necessitate a corpectomy. These growths can directly compress the spinal cord, leading to neurological deficits. Similarly, certain infections, such as osteomyelitis, can destroy the vertebral bone, leading to instability and compression, making corpectomy an option to remove the infected and damaged tissue.
Traumatic injuries, such as vertebral fractures that cause the bone to collapse or fragment, lead to spinal cord compression. In such cases, a corpectomy can remove the unstable or encroaching bone fragments to decompress the spinal cord and stabilize the injured segment.
The Corpectomy Procedure and Recovery
The corpectomy procedure begins with an incision, the location of which depends on the specific vertebral level being treated and the surgeon’s approach, which can be from the front (anterior) or back (posterior) of the body. Once the spine is exposed, specialized instruments are used to carefully remove the diseased or damaged vertebral body and any adjacent disc material.
After the problematic bone is removed, the gap created is filled with a graft or cage to restore spinal alignment and height. This graft can be bone taken from another part of the patient’s body, donor bone, or a synthetic implant. Metal plates and screws are then attached to the vertebrae above and below the graft or cage to provide immediate stability and promote bone fusion over several months. This internal fixation holds the spinal segment rigid while the body’s natural healing processes integrate the graft.
Following the surgery, patients remain in the hospital for several days, ranging from three to seven days, depending on the extent of the surgery and individual recovery. Pain management is a focus during this initial period, using medications for comfort. Early mobilization is encouraged, with patients beginning to sit up and walk with assistance shortly after the procedure, which helps prevent complications and promotes recovery.