63102 Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment

Name of the Procedure:

Vertebral Corpectomy (Vertebral Body Resection), Partial or Complete, Lateral Extracavitary Approach with Decompression of Spinal Cord and/or Nerve Root(s) (e.g., for Tumor or Retropulsed Bone Fragments); Lumbar, Single Segment

Summary

A vertebral corpectomy is a surgical procedure that involves removing part or all of a vertebral body in the lower spine (lumbar region) through a side (lateral) approach. This procedure is performed to relieve pressure on the spinal cord or nerve roots, which can be caused by conditions such as tumors or displaced bone fragments.

Purpose

The procedure addresses conditions like spinal tumors, severe fractures, or bone fragments that compress the spinal cord or nerve roots. The primary goal is to alleviate pain, improve neurological function, and prevent further spinal damage.

Indications

• Spinal cord or nerve root compression causing severe pain, weakness, or numbness.
• Spinal tumors or metastatic lesions.
• Severe vertebral fractures with bone fragments.
• Degenerative spine disease unresponsive to conservative treatments.

Preparation

• Patients may be required to fast for a specific period before surgery.
• Medication adjustments might be necessary, such as stopping blood thinners.
• Preoperative imaging studies like MRI or CT scans and spinal assessments are essential.
• Blood tests and a physical examination to ensure patient readiness for surgery.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made through the side of the body to access the affected vertebra.
3. Muscles and tissues are carefully retracted to expose the spine.
4. Part or all of the targeted vertebral body is removed.
5. If necessary, spinal decompression is performed to relieve pressure on the spinal cord or nerve roots.
6. Stabilization using surgical implants such as plates, screws, or rods may be conducted.
7. The incision is closed with sutures or staples, and a dressing is applied.

Duration

The procedure typically takes 3 to 5 hours, depending on the complexity and the specific case.

Setting

This surgery is performed in a hospital's operating room.

Personnel

• Orthopedic or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Nerve injury
• Spinal instability
• Implant failure
• Prolonged pain or insufficient symptom relief

Benefits

• Relief from pain and neurological symptoms
• Improved mobility and quality of life
• Prevents further spinal damage

Recovery

• Post-procedure hospital stay of several days.
• Pain management with medications.
• Physical therapy is often recommended.
• Initial recovery period of a few weeks, with full recovery taking several months.
• Follow-up appointments for monitoring progress and removing sutures/staples.

Alternatives

• Non-surgical treatments like physical therapy, medications, or spinal injections.
• Other surgical options such as laminectomy or spinal fusion.
• Pros and cons should be discussed with a healthcare provider based on individual conditions and overall health.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-procedure, the patient might experience pain, swelling, and discomfort at the incision site, managed with medications. Physical therapy and gradual activity resumption are typically part of the recovery process. Regular follow-ups ensure proper healing and address any complications.