What is Cervical Corpectomy?
Cervical corpectomy is an operation to remove a portion of adjacent vertebral bodies and intervertebral discs for decompression of the cervical spinal cord and spinal nerves. To provide stability, a bone graft with or without a metal plate and screws is used. Cervical corpectomy may be performed from level C3 to C7. Although it usually involves the excision of only a single vertebra along with its adjacent discs, a cervical corpectomy can be extended to include as many as four vertebrae if necessary.
Cervical Spine Anatomy
Before going ahead, you should start with some understanding of the general anatomy of your neck. This includes becoming familiar with the various parts that make up the neck and how these parts work together.
The cervical spine is made up of the first 7 vertebrae, referred to as C1-C7. It functions to provide mobility and stability to the head while connecting it to the relatively immobile thoracic spine.
Why Cervical Corpectomy?
If spinal stenosis is the main cause of your neck pain, then the spinal canal must be made larger and any bone spurs pressing on the nerves must be removed. One way that this is done is with a cervical corpectomy. Corpectomy means “remove the body” (in this case the body of the vertebra).
How is Cervical Corpectomy Done?
During Cervical Corpectomy surgery, the spine surgeon creates a one to two-inch incision on the back of the neck (cervical), accessing the spine. The diseased bone and discs are carefully removed, lifting pressure off the irritated spinal cord. Bone graft, screws, and metal plates are secured to the vertebrae in order to help straighten the spinal column and ensure proper healing.
Cervical Corpectomy Procedure in Detail
An effective procedure for removing the pressure on the spinal cord causing spinal stenosis and cervical myelopathy is to remove the vertebrae that are putting pressure on the front of the spinal canal. This means that the largest part of several of the vertebra must be removed – the vertebral bodies and the discs between each vertebra.
At the beginning of the cervical corpectomy procedure, an incision is made in the front of your neck right beside your trachea (windpipe). The muscles are moved to the side. The arteries and nerves in the neck are protected as well.
Once the spine is reached from the front, each disc and vertebra are identified using an X-ray to make sure that the right vertebrae and discs are being removed. Once this is determined, the vertebrae and discs are removed all the way back to the spinal cord. Any bone spurs that are found sticking off the back of the vertebra are removed as well. Great care is taken while performing cervical corpectomy to not damage the spinal cord and nerve roots.
Once the problem-causing vertebral bodies have been removed, the space must be filled with something. This space is usually filled with a structural bone graft. A strut graft can either be an “autograft” that is taken from the small bone in your leg, or it can be an allograft, which is bone taken from someone else.
You will probably also need to be placed in a halo jacket to hold your head perfectly still while the healing occurs and the vertebrae fuse. You should be aware that this is a very uncommon procedure.
Diagnostic Procedures Done Prior to Cervical Corpectomy
To determine whether your condition requires treatment with a cervical corpectomy, your doctor will examine your spine and take your medical history, and may order an x-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of your cervical vertebrae. A cervical corpectomy is typically recommended only after conservative treatment methods fail.
However, a number of factors are taken into consideration before making recommendation for cervical corpectomy surgery which include the condition to be treated, your age, health, and lifestyle, and your anticipated level of activity following surgery. Please discuss this treatment option thoroughly with your spinal care provider.
Rehabilitation Following Cervical Corpectomy
Patients routinely remain in the hospital after a corpectomy surgery. Postoperative pain control is achieved with the use of IV pain medication with or without oral pain medications. Patients are discharged home on oral pain medication. It is very important that the patient who has undergone cervical corpectomy is comfortable with walking before the discharge. The ultimate goal is to make sure the gastrointestinal and urinary systems are working appropriately. Patients must be able to tolerate foods and urinate without difficulty before leaving the hospital. A neck brace or collar is usually recommended. Your surgeon may ask you to wear your collar at all times. The brace limits neck motion so that bone can heal properly. It is important to wear your collar as directed.
Possible Risks and Complications of Cervical Corpectomy
With any surgery, there is a risk of complications. When surgery is done near the spine and spinal cord these complications (if they occur) can be very serious. Complications of Cervical Corpectomy could involve subsequent pain, impairment, and the need for additional surgery. You should discuss the complications associated with surgery with your doctor before the surgery. Only your doctor can evaluate your condition and inform you of the risks of any medical treatment he or she may recommend.
Some of the complications of Cervical Corpectomy are listed below:
- Nerve root damage
- Damage to the spinal cord
- Graft dislodgment
- Damage to the trachea/esophagus
- Continued pain.
When Should I Call My Doctor?
Contact your doctor if you have any of the following signs and symptoms:
- Increasing redness or swelling around your incision with or without any soreness or if the edges of your incision start coming apart.
- Drainage from your incision, especially if yellow/green and/or bad smelling.
- Fever over 101 F.
- Increase or sudden bruising around the incision that wasn’t there before.
- Increasing pain that you cannot control.
- Any new numbness or tingling in your hands or fingers on either side.
- New weakness of your arm, hand or legs.
To sum up, all treatment and outcome results are specific to the individual patient. You must always consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to the cervical corpectomy procedure.