Name of the Procedure:

Vertebral Corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment

Summary

A vertebral corpectomy is a surgical procedure that involves removing part or all of a vertebral body from the cervical spine to relieve pressure on the spinal cord or nerve roots. This is done through an anterior (front) approach.

Purpose

The procedure addresses conditions like spinal cord compression, severe vertebral fractures, tumors, or infections that impact the cervical vertebrae. The main goal is to alleviate pain, improve function, and prevent further neurological damage.

Indications

• Severe neck pain unresponsive to conservative treatment.
• Neurological deficits such as weakness or numbness.
• Radiographic evidence of vertebral body damage or compression.
• Conditions like traumatic fractures, spinal tumors, or infections.

Preparation

• Patients may need to fast for a certain period before surgery.
• Medications may need adjustment, particularly blood thinners.
• Preoperative imaging studies like MRI or CT scans are required.
• Pre-surgical assessments to evaluate overall health and anesthesia risk.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the front of the neck.
3. The surgeon carefully moves aside muscles and soft tissues to expose the cervical spine.
4. The affected vertebral body or bodies are partially or completely removed to decompress the spinal cord or nerve roots.
5. If necessary, a graft or spinal fusion device is inserted to stabilize the spine.
6. The incision is closed, and the patient is taken to recovery.

Duration

The procedure typically takes 2 to 4 hours, depending on the extent of the surgery and the number of segments involved.

Setting

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

Personnel

• Orthopedic spine surgeon or neurosurgeon
• Anesthesiologist
• Surgical nurses and technicians
• Surgical assistants

Risks and Complications

• Infection
• Excessive bleeding
• Damage to surrounding tissues, including the esophagus or trachea
• Spinal cord or nerve injury
• Risks related to anesthesia
• Post-surgical pain or difficulties swallowing
• Potential need for further surgery

Benefits

• Relief from severe pain
• Improvement or stabilization of neurological function
• Prevention of further spinal cord or nerve damage Expected benefits are often noticed within a few weeks to months post-surgery.

Recovery

• Initial hospital stay of 3 to 7 days.
• Limitations on physical activities, including avoiding heavy lifting and strenuous activities for several weeks.
• Follow-up appointments for wound care and monitoring.
• Physical therapy may be recommended for optimal recovery.

Alternatives

• Conservative treatments such as physical therapy, medications, and spinal injections.
• Other surgical options like laminectomy or discectomy, depending on the specific condition and severity.
• Pros: Non-surgical methods have fewer immediate risks.
• Cons: Non-surgical methods may not provide the desired relief or could cause conditions to worsen.

Patient Experience

• During the procedure, the patient will be under general anesthesia and not feel pain.
• Post-procedure experiences may include neck pain, difficulty swallowing, or limited mobility, managed with pain medications and supportive care.
• Long-term, patients typically experience a significant reduction in pain and improved quality of life.