What is a Vertebral Corpectomy?
Neck pain and lower back pain are two of the most common conditions to affect adults. According to studies, one of these two t
ypes of back pain accounts for many days of missed work in our country. Many who suffer from chronic back pain e
xperience diminished quality of life due to the physical limitations set by the level and frequency of pain. Often, the underlying cause of chronic back or neck pain is nerve compression. Nerves span off of the spinal cord at the center of the spine. These nerves then exit the spinal column between two bones, or vertebrae. The space in between vertebrae is typically held by discs, small, cushiony fixtures that have a gelatinous center. Disc space may diminish over time due to wear and tear or injury. Decreased disc space causes nerve compression and pain. Vertebral corpectomy is a procedure that may be performed on the neck or lumbar spine to repair spinal stenosis or myelopathy. The corpectomy removes some or all of the affected vertebra and disc. Structure is then replaced with a bone graft or bone fusion. Cervical corpectomy may be performed to reduce pain, weakness, and numbness in the neck, shoulders, arms, or hands. Lumbar corpectomy may be performed to reduce pain associated with bone spurs and herniate discs in the low back, leading to pain, stiffness, weakness, and other symptoms in the lumbar area or down the legs.
Am I Candidate for a Vertebral Corpectomy?
When possible, symptoms of nerve compression are treated with non-surgical modalities. Depending on the affected spinal segment, this may include medication, physical therapy, steroid injections, narcotic analgesics, and structural support such as a low-back brace or soft cervical collar. Physical therapy may retrain the muscles around the spine to compensate for nerve compression. All other modalities are geared toward pain relief. If conservative approaches do not achieve the desired outcome, which is an improvement in comfort, mobility, and quality of life, surgery may be a more appropriate treatment approach. Optimally, patients should be in good physical health and should not smoke. Before discussing lumbar corpectomy, surgeons usually conduct a thorough health history and physical examination. Special imaging is also typically ordered to accurately identify the condition of the spine and the extent of the injury. Tests such as x-rays, CT scan, or MRI may be ordered.
Preparing for a Vertebral Corpectomy
During the consultation for vertebral corpectomy, it is important to discuss all medications that are being taken, including over-the-counter medications and supplements. Also, tell your doctor if you have allergies to latex or any medications. Blood-thinning drugs will need to be avoided before surgery. Certain lab tests may be ordered. Patients are provided with a detailed pre-operative instruction guide to help them fully prepare for their back or neck surgery. We encourage patients to contact our office ahead of their procedure if they have any questions regarding preparation, the procedure itself, or recovery.
Vertebral Corpectomy Procedure
The vertebral corpectomy procedure is performed in a hospital operating room under general anesthesia. The surgery takes 3-4 hours to complete. An incision is made in the side of the body at the affected area, most commonly in the region of the cervical or lumbar spine. This provides access to the spinal segment that needs to be corrected. As needed, organs or tissue are gently moved aside in order to clearly visualize the spine. In order to correct spinal compression, the discs above and below the affected vertebra are removed, along with the middle portion of the bone. A bone graft and metal hardware are inserted to stabilize the spine after the damaged structures have been removed. During the recovery period of 6 weeks to 3 months, the bone graft will fuse to the vertebrae above and below the one that was removed.
Vertebral Corpectomy Results
Results of vertebral corpectomy are generally quite good, according to studies. The objective of this procedure is to improve a patient’s comfort and physical function and to prevent further decline in spinal health. Some studies indicate that 80 to 91% of patients who undergo vertebral corpectomy experience good or excellent results. In many cases, the improvements achieved with vertebral corpectomy are noticed gradually over the course of several weeks. Physical therapy may be prescribed as a follow-up to surgery to enhance the final outcome of care.
What Can I Expect After Surgery?
Patients may remain in the hospital for a few days after surgery. Before being released, patients may be visited by occupational or physical therapists who will demonstrate how to safely get in and out of bed and around the house. At home, post-operative recovery occurs gradually. No bending, lifting, or twisting for 4 to 6 weeks. Some patients may be instructed to wear a brace or collar. Incisions will be covered with gauze, which will need to be changed every day or two. Showering may resume immediately, taking care to keep the covered incision dry. Driving may resume 2 to 6 weeks after surgery, depending on comfort and mobility. Light-duty work and exercise may resume 6 weeks after surgery. Activity can increase as pain subsides and mobility improves. Post-surgical follow-up may be scheduled approximately 14 days after surgery to evaluate recovery.
Vertebral Corpectomy Risks
As with any type of spinal surgery, a vertebral corpectomy has certain risks associated with it. Although the procedure usually goes smoothly, patients should be aware of the following risks: possible postsurgical infection, excessive bleeding, adverse reactions to anesthesia or medication, and nerve damage.