PROCEDURES

Corpectomies

What is a corpectomy?

A corpectomy refers to the surgical removal of the vertebral body. Like a discectomy, a corpectomy aims to remove bony projections, also known as bone spurs, that increase pressure on the spinal nerves. Bony growths and herniated discs are removed surgically to alleviate pressure on the spine. Bone spurs and broken disc material can take up more room in the spinal canal which is needed for the spinal cord and nerves. A change like this is detrimental to the health of the spine and can minimise space in the canal, causing a condition known as spinal stenosis.

Spinal stenosis leads to pinching of the spinal cord and nerve roots and therefore causes significant damage to the area. The vertebrae are susceptible to damage as a result of spinal trauma, tumours and a spinal deformity. All these conditions are in dire need of a corpectomy.

Should all non-operative measures (pain medication, corticosteroid shots and physical therapy) fail to relieve pain, Dr Bomela will suggest a corpectomy for complete pain relief.

How do you perform the procedure?

Corpectomies are a series of surgical procedures to treat pain and return function to the limbs, bowel and bladder. These surgeries are performed on different regions of the spine (cervical and lumbar spine) and may differ depending on where the incision is made.

A corpectomy can be approached by making an incision along the side of the body, also known as an anterior lumbar corpectomy or the front (anterior) of the neck (cervical corpectomy) to remove damaged tissue, bone projections and damaged discs to alleviate pressure on the spinal cord.

First, in the event of an anterior cervical corpectomy, Dr Bomela will perform decompression surgery to reduce pressure on parts of the spine (spinal cord and nerves). Next, she stabilises the spinal column through spinal fusion; an implant (strut graft or cage) can help strengthen the area with the missing vertebrae. Over time the graft will unify with the natural bone in its native region. With a cage made out of artificial material, titanium or ceramic, tiny bone grafts from the removed vertebra can be threaded through to hold the cage in place. Finally, sutures are used to seal the incision, and the area is dressed in gauze.

FAQ

1. Why does Dr Bomela perform a corpectomy?

Dr Bomela will schedule a corpectomy when the patient does not respond to pain medication or the pain becomes so extreme that they cannot function any longer.
Additional symptoms that warrant surgery include:

Loss of bowel and urinary control
Trouble walking
Neurological deficits that cause weakness in the arms and legs

2. Will I need to stay overnight in the hospital after an anterior cervical corpectomy?

Major surgery stay is 5-8 days and is augmented with screws and rods. In some cases, ribs can be removed to gain access to the spinal cord. This is usually for major trauma, infections, tuberculosis and tumours.

3. What happens during a follow-up?

By the seventh post-operative day, Dr Bomela will remove the dressing or Steri strips, depending on what was used to dress the area. Four to six weeks after surgery, she will carry out an x-ray to determine how well the graft has fused. Fusion takes an average of 9 - 18 months for recovery.

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