Cervical Corpectomy

Cervical Corpectomy: Indications, Techniques, and Outcomes

Cervical corpectomy is a surgical procedure that involves removing one or more vertebral bodies in the cervical spine to alleviate spinal cord and nerve root compression.

When necessary for spinal stability, this surgery is often accompanied by supplementary posterior fixation. This article will discuss the indications, techniques, benefits, and potential risks of cervical corpectomy.

Indications for Cervical Corpectomy

Cervical corpectomy is primarily indicated for patients suffering from severe spinal cord compression due to various conditions, including degenerative disc disease, cervical spondylosis, spinal stenosis, herniated discs, and spinal tumours.

Symptoms that may warrant this procedure include neck pain, radiculopathy (nerve root compression), myelopathy (spinal cord compression), and muscle weakness or numbness in the arms or hands.

Technique of Cervical Corpectomy

Cervical corpectomy is performed under general anaesthesia with the patient positioned prone on the operating table. The procedure typically involves the following steps:

• Exposure: A midline incision is made over the cervical spine, and the muscles and soft tissues are carefully dissected to expose the affected vertebral body.
• Corpectomy: Using specialised instruments, the surgeon removes the affected vertebral body, along with the intervertebral discs above and below it, to decompress the spinal cord and nerve roots.
• Reconstruction: To restore spinal stability and alignment, a structural graft, usually made of PEEK or titanium and surrounded by bone graft material, is placed in the void created by the corpectomy.
• Supplementary posterior fixation: If necessary, additional stabilisation may be provided through the insertion of screws and rods in the posterior elements of the cervical spine.
• Closure: The muscles, fascia, and skin are closed in layers, and a drain may be placed to remove any excess fluid.

Benefits of Cervical Corpectomy

Cervical corpectomy offers several advantages to patients suffering from severe spinal cord compression, including:

• Effective decompression: The procedure effectively alleviates pressure on the spinal cord and nerve roots, providing relief from neurological symptoms.
• Restored spinal alignment: The structural graft helps to restore proper spinal alignment and stability.

Risks and Complications

As with any surgical procedure, cervical corpectomy carries potential risks, including:

• Infection: In severe cases, postoperative infection may require antibiotic treatment or additional surgery.
• Bleeding: Excessive bleeding during or after surgery may necessitate blood transfusions or further surgical intervention.
• Nerve/cord injury: Damage to nerves or the spinal cord in the area can cause temporary or permanent neurological deficits.
• Graft failure or non-union: The structural graft may not fuse properly, necessitating additional surgery to achieve spinal stability.

Cervical corpectomy is an effective surgical treatment for severe spinal cord compression in the cervical spine, providing significant relief from neurological symptoms and potentially improving the patient's quality of life.

Often, the goal of surgery is to prevent deterioration in spinal cord function. However, potential risks and complications should be carefully considered and discussed with the patient and surgeon before proceeding with the surgery.

Proper patient selection, meticulous surgical technique, and comprehensive postoperative care can significantly improve outcomes and overall patient satisfaction.