63103 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); thoracic or lumbar, each additional segment (List se

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 or Lumbar, Each Additional Segment

Summary

A vertebral corpectomy is a surgical procedure where part or all of a vertebral body is removed from the spine to relieve pressure on the spinal cord and/or nerve roots. This approach is often used in the thoracic or lumbar regions of the spine, allowing surgeons to access the spine from the side (lateral extracavitary approach).

Purpose

This procedure addresses conditions such as spinal tumors, severe fractures, or herniated discs that push bone fragments or other material into the spinal canal, causing compression. The goal is to decompress the spinal cord and/or nerve roots, alleviate pain, and improve neurological function.

Indications

• Spinal tumors
• Severe trauma or fractures with retropulsed bone fragments
• Herniated discs causing spinal cord or nerve root compression
• Severe, debilitating back or leg pain unresponsive to conservative treatment

Preparation

• Patients are usually instructed to fast 8-12 hours before surgery.
• Medication adjustments may be necessary, particularly blood thinners.
• Pre-operative imaging, such as MRI or CT scans, and blood tests are typically required.

Procedure Description

1. The patient is positioned on their side, and general anesthesia is administered.
2. An incision is made on the side of the thoracic or lumbar region to access the spine.
3. Muscles and tissues are carefully retracted to expose the vertebral body.
4. Part or all of the vertebral body is removed using specialized surgical instruments.
5. Any material compressing the spinal cord or nerves is carefully excised.
6. The spine is often stabilized using bone grafts, rods, or screws.
7. The incision is closed, and the patient is moved to recovery.

Duration

The procedure typically takes 3-6 hours, depending on the complexity and number of vertebral segments involved.

Setting

Performed in a hospital operating room under general anesthesia.

Personnel

• Spine surgeons (orthopedic or neurosurgeons)
• Anesthesiologists
• Surgical nurses
• Radiologists (for intraoperative imaging)

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Spinal fluid leak
• Blood clots
• Risks associated with anesthesia

Benefits

• Relief from pain and neurological symptoms
• Stabilization of spinal structure
• Improved mobility and quality of life
• Potential to remove spinal tumors

Recovery

• Patients typically stay in the hospital for a few days post-surgery.
• Pain management includes medications and physical therapy.
• Restrictions on heavy lifting and strenuous activities for several weeks.
• Follow-up appointments to monitor healing and spinal alignment.

Alternatives

• Conservative treatments: physical therapy, medications, and spinal injections.
• Other surgical options: laminectomy, discectomy, or spinal fusion.
• Each alternative has its indications, benefits, and limitations compared to a vertebral corpectomy based on the specific condition.

Patient Experience

• During the procedure: The patient will be under general anesthesia and won’t feel any pain.
• After the procedure: Pain and discomfort managed with medication, gradually improving with time. Follow-up care includes physical therapy and regular medical check-ups to ensure proper recovery.