63304 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical

Name of the Procedure:

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

Summary

A vertebral corpectomy is a surgical procedure to remove part or all of the vertebral body in the cervical spine. This operation is performed to remove lesions or tumors within the spinal canal.

Purpose

The procedure addresses conditions such as spinal tumors, metastases, or other lesions causing spinal cord compression. The goals are to alleviate pain, restore spinal stability, and improve neurological function.

Indications

The procedure is indicated for patients with:

• Tumors or lesions in the cervical spine
• Persistent pain not relieved by other treatments
• Neurological deficits due to spinal cord compression
• Evidence of spinal instability

Preparation

Patients should:

• Fast for at least 8 hours before surgery
• Adjust medications as instructed by their doctor
• Undergo diagnostic tests such as MRI, CT scans, and blood tests to evaluate the area and plan the surgery

Procedure Description

1. The patient is placed under general anesthesia.
2. The surgeon makes an incision in the front or back of the neck.
3. Muscles and tissues are carefully moved to expose the vertebrae.
4. Specialized surgical tools are used to remove part or all of the affected vertebra.
5. The lesion is excised, and any necessary spinal stabilization (e.g., with screws or a plate) is performed.
6. The surgeon closes the incision with sutures or staples.

Duration

The procedure typically takes 3-6 hours, depending on the extent of the disease and complexity of the surgery.

Setting

The surgery is performed in a hospital operating room.

Personnel

• Orthopedic or neurosurgeon
• Surgical assistants
• Anesthesiologist
• Operating room nurses
• Radiologic technologist (if intraoperative imaging is used)

Risks and Complications

Common risks:

• Infection
• Blood loss
• Pain at the surgical site

Rare risks:

• Spinal cord or nerve damage
• Spinal instability requiring further surgery
• Non-union or failure of fusion hardware

Benefits

• Relief from pain and neurological symptoms
• Stabilization of the spine
• Potential removal of the disease-causing lesion.

Patients might realize these benefits within weeks to months after surgery, depending on individual recovery.

Recovery

Post-procedure care includes:

• Pain management with medications
• Physical therapy to aid in recovery
• Gradual return to normal activities The typical recovery period is several weeks to months, with restrictions on heavy lifting and strenuous activities. Follow-up appointments are necessary to monitor healing and spinal stability.

Alternatives

Alternative treatments might include:

• Radiation therapy or chemotherapy (for certain tumors)
• Less invasive spinal surgery techniques
• Pain management strategies (e.g., medications, physical therapy)

Each alternative has its pros and cons, such as varying degrees of invasiveness, effectiveness, and recovery times.

Patient Experience

During the procedure, the patient will be under general anesthesia and feel no pain. After surgery, there will be some discomfort and pain, which will be managed with medications. Initial recovery involves hospital stay and gradually increasing physical activity levels as strength and mobility improve.