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Anterior Cervical Corpectomy

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A corpectomy is an effective procedure for removing spinal cord pressure by removing one or several vertebral bodies.



Anatomy

The spine is composed of individual bones called vertebrae. There are seven cervical vertebrae, named C1-C7, designed for flexibility and movement. The first two cervical vertebrae are very specialized to allow us to turn our head from side to side. The first cervical vertebra (or C1) is called the atlas and the second cervical vertebra (C2) is called the axis. The C1 vertebra connects the skull to the cervical spine and is formed like a ring that sits on top of C2. The C2 vertebra has a bony knob that fits into the front portion of the ring of the C1 vertebra. This bony knob is called the odontoid process or dens. The cervical spine has a lordotic shape, or a backwards “C” shape.

The vertebrae are stacked one on top of another and are separated by discs, which act as an elastic cushions or shock absorbers. Discs have a soft center, the nucleus, surrounded by a tough outer ring, the annulus. Discs allow motion between the vertebrae. The interbody space is the disc space that is located between the vertebral body bones. Each vertebral segment creates a bony circle, called the spinal canal that protects the spinal cord and spinal nerves.  The spinal cord, which is the nerve center of the body, connects the brain to the rest of the body. The spinal cord and nerves travel from the cervical spine down to the lowest point of your spine, the sacrum. Spinal nerves exit the spinal canal between the vertebrae at each level. Two nerves exit each level, one on the left and one on the right. These nerves exit through openings called foramen. The discs, bony structures, ligaments and strong muscles all work together to stabilize the spine.

Anterior Cervical Corpectomy

This surgical procedure is done under general anesthesia, meaning the patient goes to sleep. During the surgery the patient lies face up on a special surgical bed. The procedure is performed through a small incision on the front of the neck, usually in the neck’s natural crease. The trachea (windpipe), esophagus (stomach tube), and blood vessels lie in front of the spine and are carefully moved aside. This can cause some neck swelling after the surgery.

Once the surgeon safely creates a window to see the spine, the diseased vertebral body bone and disc is removed with surgical tools. The space that the vertebral bones used to occupy must be replaced. This is typically done with a structural bone graft (strut) or a plastic cage. This spans the defect and provides structural support to the front of the spine. A metal plate and screws are used to support and facilitate the fusion process. If the fusion is successful, the vertebrae will only move as one unit. This reduces future problems at this spinal segment. If the bones do not fuse as planned this is called a nonunion, or pseudarthrosis

Any spine surgery has surgical risks involved. You need to discuss these with your surgeon at your pre-operative appointment. Read about Preparing for Spine Surgery and General Complications from Spine Surgery.

Post-Operative Hospital Care

Patients usually remain in the hospital after a corpectomy surgery. Postoperative pain control will be achieved with the use of IV pain medication and/or oral pain medications. Patients are discharged home on oral pain medication. Patients need to be comfortable with walking. The final goal is to make sure the gastrointestinal and urinary systems are working appropriately. Patients must be able to tolerate foods and urinate without difficulty before leaving the hospital. A neck brace or collar may be worn after surgery. Your surgeon may require you to wear your collar at all times. The brace limits neck motion so that bone can heal properly. It is important to wear your collar as directed.

Read about Recovery from Spine Surgery and make sure you understand your post-operative plan before your surgery date.

Summary

Anterior Cervical Corpectomy is an approved and effective method for fusing the cervical spine to treat cervical spinal stenosis. Complications may occur but are not common. The majority of patients are satisfied with their pain relief and the results of their surgery. It is important that all patients are physically and psychologically prepared. All patients should stop smoking prior to any surgery, as smoking is extremely detrimental to your spine health, potential bone healing and successful surgical outcomes. Please review additional details with your surgeon prior to your surgery.

Anterior Cervical Corpectomy

 

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