63300 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical

Name of the Procedure:

Vertebral Corpectomy (Vertebral Body Resection), Partial or Complete, for Excision of Intraspinal Lesion, Single Segment; Extradural, Cervical

Summary

A vertebral corpectomy is a surgical procedure to remove part or all of a vertebral body in the cervical spine. It is performed to excise lesions located outside the spinal cord but still within the spinal canal. This helps alleviate pressure on the spinal cord and nerves.

Purpose

The main purpose of a vertebral corpectomy is to address cervical spine problems caused by intraspinal lesions, such as tumors or abnormal growths that are putting pressure on the spinal cord or nerves. The goal is to relieve this pressure, reduce pain, and restore normal neurological function.

Indications

Specific Symptoms or Conditions:

• Spinal cord compression
• Severe neck pain or numbness
• Weakness or loss of coordination in arms or legs
• Difficulty walking or balancing

Patient Criteria:

• Diagnosis of extradural lesions such as benign or malignant tumors
• Unresponsive to conservative treatments like medication or physical therapy

Preparation

Pre-procedure Instructions:

• Fasting for at least 8 hours before surgery
• Adjustments to current medications as directed by the healthcare provider
• Stopping blood-thinning medications prior to surgery

Diagnostic Tests:

• MRI or CT scans to visualize the lesion
• Blood tests to check overall health

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made in the front of the neck to access the cervical spine.
3. Exposure: The muscles and tissues are carefully moved aside to expose the vertebral body.
4. Resection: The affected part or the entirety of the vertebral body is removed.
5. Lesion Excision: The intraspinal lesion is carefully excised.
6. Stabilization: The spine may be stabilized using a bone graft or metallic hardware such as plates and screws.
7. Closure: The incision is closed with sutures and covered with a sterile dressing.

Tools and Equipment:

• Scalpel, retractors, bone cutters, and imaging devices
• Hardware for spinal stabilization

Duration

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

Setting

This procedure is performed in a hospital operating room.

Personnel

• Neurosurgeon or orthopedic spine surgeon
• Anesthesiologist
• Surgical nurses
• Physician assistants or surgical technicians

Risks and Complications

• Common Risks: Infection, bleeding, and pain at the incision site
• Rare Risks: Spinal cord injury, nerve damage, paralysis, or complications from anesthesia

Benefits

• Relief from pain and neurological symptoms
• Improved mobility and function
• Potential halt or regression of lesion growth

Recovery

Post-procedure Care:

• Hospital stay of a few days for monitoring
• Pain management including medications
• Physical therapy to regain strength and mobility

Expected Recovery Time:

• Initial recovery in 6 to 8 weeks
• Full recovery may take several months

Restrictions and Follow-Up:

• Avoid heavy lifting and strenuous activities for a specified period
• Follow-up appointments to monitor healing and spinal stability

Alternatives

• Non-surgical options like medications, physical therapy, and spinal injections
• Less invasive surgical procedures, if appropriate

Pros and Cons:

• Non-surgical options are less risky but may not provide enough relief for severe cases.
• Less invasive surgeries have quicker recovery times but may not be as effective in removing large or complex lesions.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, some pain and discomfort are expected around the incision site. Pain management will include prescribed medications and possible physical therapy to ensure a comfortable recovery. Frequent follow-ups are critical to monitor progress and address any issues timely.