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What is a Corpectomy?

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What is a Corpectomy?



A corpectomy is a precise surgical procedure that involves the removal of a portion of a vertebra and the adjacent intervertebral discs. The primary objective of this operation is to alleviate the pressure on the spinal nerves, which can cause numerous health complications if left untreated. This intricate procedure can be performed in various regions of the spine, depending on the specific needs of the patient.


When the operation is carried out in the neck area, it is referred to as a cervical corpectomy. This procedure is often utilized to address issues such as herniated discs or spinal stenosis that are causing discomfort or functional issues in the cervical region of the spine.


On the other hand, when the procedure takes place in the lower back area, it is known as a lumbar corpectomy. This type of procedure is typically used to treat conditions such as degenerative disc disease or spondylolisthesis that affect the lumbar region of the spine.


Upon completion of a corpectomy, it is quite common for a spine fusion surgery to follow. This additional procedure is crucial as it involves the use of a bone graft which can either be autograft (from the patient's own body) or allograft (from a donor). This grafting process promotes new bone growth, replacing the removed vertebra and disc, and restoring the natural spacing between the vertebrae.


In many instances, the attachment of a metal plate with screws to the neighboring vertebrae is also undertaken to provide additional spinal stability. This is because a corpectomy, while relieving nerve pressure, can compromise the overall strength of the affected vertebra. By adding these stabilizing elements, the spine's integrity is upheld, and the patient's recovery prospects are enhanced.


Cause


Nerve compression in the cervical vertebra, the uppermost parts of the spine, can lead to neck pain. This discomfort can also manifest as pain, numbness, and weakness that extends into the shoulders, arms, and hands, affecting the patient's ability to perform daily tasks. Similarly, when the nerve compression occurs in the lower back or the lumbar region of the spine, it can lead to back pain. This condition can also cause pain, numbness, and weakness that extends into the hips, buttocks, and legs, often interfering with the person's mobility. Both of these conditions, which can significantly impact a person's quality of life, can be caused by:


1.Infection

2.Tumor

3.Spinal fracture

4.Degenerative spinal conditions


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Types of Corpectomy


Anterior Cervical Corpectomy


An Anterior Cervical Corpectomy and Fusion is a complex surgical procedure that involves the meticulous removal of vertebral bone and intervertebral disc material. This intricate operation is primarily performed with the objective of relieving undue pressure on the delicate spinal cord and the spinal nerves nestled within the cervical spine, also known as the neck region. The procedure usually involves the surgeon accessing the cervical spine from the front, a method commonly referred to as the anterior approach.


This surgical intervention provides a pathway to alleviate the symptoms associated with various spinal conditions that can cause severe discomfort and hinder normal activities. The Anterior Cervical Corpectomy and Fusion surgery is typically recommended only when conservative treatment methods, such as medication, physical therapy, and lifestyle changes, have been explored and proven unsuccessful. It is considered the next step in treatment for those who have not found sufficient relief from these non-invasive options.


Who Needs Cervical Corpectomy?


Anterior Cervical Corpectomy is suggested for patients who have nerve compression in the cervical spine. The nerve compression in the cervical spine causes neck pain, numbness and weakness in the hands, arms, and shoulders.


This procedure is also suggested for patients who show symptoms such as pins and needles, tingling, or weakness in the hands and arms. More serious symptoms can be stumbling, loss of balance, and a loss of control of bowel and bladder.


Cervical Corpectomy is recommended only for patients who have gone through conservative treatment but these treatments failed.


Anterior Lumbar Corpectomy


An Anterior Lumbar Corpectomy and fusion is a comprehensive surgical procedure. In this operation, certain portions of vertebral bone and intervertebral disc material are meticulously extracted to alleviate the pressure applied on the spinal cord and the spinal nerves specifically located in the lumbar spine, or the lower back region. This clinical procedure is primarily designed to improve the patient's quality of life by reducing pain and improving mobility. The procedure typically involves accessing the spine through an anterolateral approach, a strategic method that allows the surgeon to approach the spine from the front and the side.


The inclusion of spinal fusion in this procedure is usually necessary due to the significant amount of vertebral bone and disc material that must be removed to achieve sufficient decompression of the neural structures. This decompression is essential to alleviate the symptoms and improve the overall neurological function. The fusion process helps in stabilizing the spine and provides a solid base for the new bone to grow, thus ensuring the structural integrity of the spine post-operation.


Who Needs Lumbar Corpectomy?


The surgical procedure known as Lumbar Corpectomy and Fusion is often recommended for patients who are suffering from conditions that have resulted in diseased or damaged vertebrae in the lower region of the spine. These conditions can range from a traumatic spinal fracture to the presence of a tumor or a severe infection that has adversely affected the vertebrae.


The primary issue with these conditions is that the diseased or damaged vertebrae can exert pressure on the nerve root, leading to it being pinched and blocked. This not only disrupts the normal functioning of the nerve but also results in significant pain in the lower spine, severely impacting the patient's quality of life.


The Lumbar Corpectomy and Fusion surgery addresses this issue by removing the problematic vertebrae and replacing it with a bone graft, thereby relieving the pressure on the nerve root. Furthermore, this procedure also serves the additional purpose of correcting any deformities that may have developed in the spinal column as a result of the disease or damage. This can significantly improve the patient's posture and overall physical health.


Corpectomy



How does a Corpectomy Help Spine Pain?


The vertebral discs, the soft, gel-like cushions that sit between the vertebrae of the spine, naturally undergo a process of degeneration over time. This is an inevitable part of the aging process, and it involves the gradual breakdown and loss of these essential components of the spinal column. This loss of cushioning function can have a significant impact on the overall health of the spine.


As the discs degenerate and their cushioning ability diminishes, the vertebrae, the individual bones that make up the spine, can begin to experience excessive wear and tear. This can cause them to change shape and develop abnormal growths known as bone spurs, which can further disrupt the normal functioning of the spine.


In addition to these changes, the ligaments that connect the vertebrae and help to keep the spine stable can become thickened over time. This thickening can contribute to a narrowing of the spinal canal, a condition known as spinal stenosis.


All of these changes can put increased pressure on the spinal nerves that run through the spinal canal. This can result in a range of unpleasant symptoms, including persistent pain, numbness, and muscle weakness. These symptoms can significantly impact a person's quality of life and their ability to carry out everyday tasks.


In situations such as these, a procedure known as a discectomy, which involves the surgical removal of an intervertebral disc, may not provide ample decompression of the spinal cord and nerve roots to effectively alleviate the patient's pain or restore their mobility. This is especially the case when the degeneration of the disc has reached a severe level, causing significant discomfort and limitation to the patient's range of motion. In these instances, more extensive surgical interventions may be needed to fully address the patient's symptoms and improve their quality of life.


The surgery might be recommended in certain scenarios when health conditions become severe and a medical intervention becomes necessary. One such instance is when spinal tumors, which are abnormal growths within the spine, start pressing on the spinal nerves. This undue pressure can cause considerable discomfort and pain, and if left untreated, it can lead to severe complications. Additionally, the surgery can also be recommended in cases of traumatic spinal injury. Instances of such injuries include falls, accidents, or any other event that causes severe damage to the spine.


During the procedure known as corpectomy, the vertebral body that has been affected is meticulously removed. This is a critical process that must be performed with utmost precision to ensure that the remaining structure of the spine is not compromised. Once the affected part is successfully extracted, the vacated space is then reconstructed. This reconstruction typically involves the use of materials such as titanium, plastic (more specifically, Polyether ether ketone or PEEK), or carbon fiber cages. These materials are carefully chosen for their strength and compatibility with the human body.


This reconstruction process is essential to restore the structural integrity and function of the spine. Following the reconstruction, bone is then grafted onto the area. This is a crucial step as it promotes fusion between the vertebra that has been operated on and the adjacent vertebrae. This fusion process is essential for regaining stability and function of the spine.


It should be noted that often, the vertebra is further stabilized by securely attaching it to the neighboring vertebrae. This is typically achieved using screws that are firmly held in place by rods. This additional step further ensures the stability of the spine post-operation.

Additionally, a plate with screws may be placed upon the area of the vertebral body where the bone was initially removed. This is done to facilitate the fusion process. This plate acts as a supportive structure, promoting proper alignment and fusion of the vertebrae, ultimately leading to a successful recovery and restoration of spinal function.


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