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); Thoracic, Single Segment

Summary

In layman's terms, a vertebral corpectomy is a surgical procedure to remove part or all of a vertebral body, typically to relieve pressure on the spinal cord or nerve roots caused by a tumor or displaced bone fragments. This procedure specifically addresses a single segment in the thoracic spine using a side (lateral extracavitary) approach.

Purpose

This surgery addresses conditions such as spinal tumors, fractured vertebrae, or displaced bone fragments that compress the spinal cord or nerve roots in the thoracic region. The primary goal is to alleviate pain, restore neurological function, and prevent further spinal cord damage.

Indications

• Tumors in the thoracic spine.
• Retropulsed bone fragments causing spinal cord compression.
• Severe vertebral fractures.
• Progressive neurological deficits due to spinal cord or nerve root compression.
• Patients who have not responded to conservative treatments.

Preparation

• Patients are typically advised to fast for at least 8 hours before the procedure.
• Medication adjustments may be required, especially blood thinners.
• Pre-operative imaging like MRI or CT scans are conducted to assess the extent of the problem.
• Pre-surgical consultations with the surgical team and anesthesiologist.

Procedure Description

1. The patient is positioned on their side or stomach, depending on the surgeon's preference.
2. General anesthesia is administered to ensure the patient is unconscious and pain-free.
3. A lateral incision is made in the thoracic region to access the spine.
4. Muscles and tissues are carefully separated to expose the affected vertebral segment.
5. Specialized surgical tools are used to remove part or all of the vertebral body.
6. Decompression is performed to relieve pressure on the spinal cord or nerve roots.
7. Bone grafts or implants may be inserted to stabilize the spine.
8. The incision is closed, and sterile dressings are applied.

Duration

The procedure typically takes between 4 to 6 hours, depending on the complexity of the case.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Orthopedic spine surgeon or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Scrub technician
• Possibly a neurologist for intraoperative monitoring

Risks and Complications

• Infection
• Bleeding or hematoma formation
• Damage to spinal cord or nerve roots
• Spinal instability
• Respiratory complications
• Need for re-operation
• Blood clots

Benefits

• Relief from pain and neurological symptoms.
• Stabilization of the spine.
• Prevention of further spinal cord damage.
• Improvement in quality of life.

Recovery

• Patients may need to stay in the hospital for several days post-operation.
• Pain management will be administered through medications.
• Physical therapy may be required to regain strength and mobility.
• Full recovery could take several months, with follow-up appointments to monitor progress.

Alternatives

• Conservative treatments like physical therapy and pain management.
• Spinal fusion with or without instrumentation.
• Minimally invasive spine surgery (where applicable).
• Radiation therapy or chemotherapy (for tumors).

Patient Experience

• Patients will be under general anesthesia and will not feel anything during the procedure.
• Post-procedure, there may be significant pain managed with medications.
• Expect some discomfort and restricted movement initially.
• Gradual improvement with physical therapy and adherence to post-op care instructions. Pain and discomfort should lessen over time, leading to a better quality of life.