Cervical Corpectomy
What is it?
Cervical Corpectomy is a surgical procedure that involves the removal of the vertebral body, along with adjacent intervertebral discs, for decompression of the cervical spinal cord and nerve roots. This procedure is typically indicated in cases where spinal cord compression is caused by multi-level cervical spondylotic myelopathy, tumors, fractures, or infections that a simpler discectomy cannot adequately address.
The success of cervical corpectomy largely depends on careful patient selection, meticulous surgical technique, and effective postoperative rehabilitation.
Most patients experience significant improvement in neurological symptoms post-surgery. However, potential complications such as graft displacement, nonunion, and adjacent segment disease can occur, necessitating close follow-up.
Procedure
The procedure is carried out via an anterior approach, similar to that used in anterior cervical discectomy and fusion. After a careful dissection to expose the cervical spine, the surgeon removes the affected vertebral body (or bodies) and adjacent discs.
Spinal reconstruction is necessary to maintain cervical alignment and stability following a corpectomy. This is typically achieved by placing a structural graft (an autograft, allograft, or a synthetic cage) into the corpectomy defect, followed by anterior plating for added stability. The graft choice and fixation technique depend on various factors including the extent of resection, the patient’s bone quality, and the surgeon’s preference.
The cervical corpectomy is technically demanding due to the need for precise vertebral body removal while protecting the spinal cord and nerve roots. Intraoperative neuromonitoring is often employed to ensure neural integrity. The procedure also involves risks associated with operating near major vascular and neural structures, including the carotid artery, jugular vein, and laryngeal nerves.