Many spinal problems are due to degenerative changes that occur in the discs and joints. These changes commonly take place as a natural part of aging and from the affects of daily wear and tear on the parts of your spine. Degenerative changes sometimes lead to a serious condition where pressure is put on your spinal cord. This pressure can be relieved with a corpectomy.
A corpectomy is an effective procedure for removing pressure on your spinal cord caused by degenerative conditions such as spinal stenosis. In a corpectomy, one or several vertebral bodies are removed to take pressure off your spinal cord. Corpus means “body” and ectomy means “remove.” The discs between the vertebrae are also removed.
When the degenerative vertebrae are replaced with bone graft, the procedure is called a corpectomy and strut graft. When the bodies of one or more vertebrae are taken out, a bone graft is inserted to fill the space. As the bone graft heals, it fuses to the intact vertebrae above and below it. The bone graft provides structural support to your spine.
A corpectomy procedure can be performed on any part of the spine: your cervical spine (neck), thoracic spine (mid back), or lumbar spine (low back). The approach to surgery will depend on the part of your spine that requires surgery.
In the cervical spine, a corpectomy may be performed from the front. An incision is made in the front of your neck beside your trachea (windpipe). The muscles are moved to the side. The arteries and nerves in your neck are also protected. In the thoracic and lumbar regions of your spine, a corpectomy may be performed from the side.
Upon reaching your spine, your doctor uses an X-ray to identify the correct vertebrae and discs. The vertebral bodies and discs causing problems are removed all the way back to your spinal cord. Bone spurs that extend from the back of the vertebrae toward your spinal canal are removed as well. Special care is taken to reduce the risk of damaging your spinal cord and nerve roots.
Once the vertebrae and discs have been removed, the space between the vertebrae above and below must be filled. Your doctor will typically implant a graft of bone into the space. The section of bone graft works like a “strut” to support your spine. The strut may be formed by taking bone from your hip (pelvis) or from the fibula bone in your leg. Bone taken from your own body is called autograft. Your surgeon may also use allograft, which is bone taken from a source other than your body and stored in a bone bank.
Some method of internal fixation to hold the bones and bone graft in place is normally used. The most common method is to use metal (titanium) plates and screws. The plate sits on the front of the remaining vertebrae, covering the strut graft. Screws are placed into the vertebral bodies above and below the graft to hold the plate in place and keep the bone graft from slipping.
Corpectomy is a serious and complex operation. Patients usually wear a neck brace after surgery. Some patients may need the extra support of a halo brace. Most patients do not require rehabilitation after this surgery. However, a short period of rehabilitation may be needed if you are having pain or difficulty doing routine activities. A physical therapist may work with you to design a specific exercise program. Once the fusion is healed, you may progress toward a more vigorous rehabilitation program.