Anterior Cervical Corpectomy Spine Surgery

Anterior (anatomical term for front) Cervical (neck spine) Corpectomy (removal of damaged vertebrae and intervertebral disc) is a procedure that removes damaged vertebrae and intervertebral discsfrom the spine in the neck that are compressing the spinal cord and spinal nerves, using a surgical approach through the front of the neck.The bone spur (osteophytes) growth often results in spinal stenosis and nerve compression.This surgery is performed for patients with symptomatic, progressive cervical spinal stenosis and myelopathy. It is performed to remove the bone spurs that are compressing the spinal cord and spinal nerves. In a corpectomy, the discs, bone spurs, and vertebrae are removed.

However, surgery is typically considered if:

• a patient’s symptoms do not respond to non-operative measures
• a patient’s pain is severe
• spinal cord compression resulting inprogressive neurologic deficit; numbness or weakness in the legs and arms, loss of bladder and/or bowel control, difficulty in walking
• difficultyin coordinating movements of the hands

Procedure

Pre-operative: It is important to inform the doctor if you are taking any blood thinning medications like aspirin and are allergic to any medications.

The surgery is performed utilizing general anesthesia. A breathing tube or ventilator support is used during the surgery. Preoperative intravenous antibiotics are given. The neck area is cleansed with a special cleaning solution.A 2-4 cmincision is made. The cervical fascia is gently divided. Small retractors and microscope are used to allow the surgeon to visualize the anterior part of vertebral body and discs. After the retractor is in place, an x-ray is used to confirm that the appropriate spinal level(s) is identified.Corpectomy is performedto allow the spinal cord and nerves to return to their normal size. Instruments are used to remove the bone spurs. The size of the empty disc space is measured; a graft size is chosen so as to restore the normal disc space height. A small metal plate is placedfixed to the vertebrae with screws to impart immediate stability and allow for optimal bone healing and fusion. X-rays are then used to confirm appropriate position and alignment of the graft.The wound area is washed with sterile water. The deep skin layers are closed with strong sutures and the skin is closed by special surgical glue that leaves no scar.The total surgery time is approximately 2 to 3 hours, depending on the number of spinal levels involved.

Complications

The complications that can happen due to this surgery are listed below:

• After the general anesthesia of surgery wears off, some patients experience nausea
• Nerve root damage
• Damage to the spinal cord
• Bleeding
• Infection
• Graft dislodgment
• Damage to the trachea/esophagus
• Continued pain
• Complete or partial quadriplegia.

After the procedure

Patients may need to wear a padded, plastic neck brace to reduce the stress on the neck area and decrease pain.Approporiate wound care is mandatory to ensure fast healing. Patients should not take a bath until the wound healing is complete, usually around 2 weeks after surgery.Patients are instructed to avoid bending and twisting of the neck in the acute postoperative period (first 4-6 weeks). Patients can gradually begin to bend and twist their neck after 6-8 weeks post-surgery. Patient should start driving only 3-8 weeks after surgery. Patients are generally advised to refrain from heavy work and lifting after surgery.The total recovery period ranges from 6 to 8 weeks.