Anterior Cervical Corpectomy
One of the most common neck conditions, cervical spondylotic myelopathy, often occurs with age. Over time, the normal wear-and-tear effects of aging can lead to a narrowing of the spinal canal. This compresses, or squeezes, the spinal cord. CSM can cause a variety of symptoms including pain, numbness, and weakness.
Multiple surgical techniques exist for treating CSM. Spinal surgeons perform surgery with a goal of opening the space for the spinal cord, or “decompressing” the spinal canal. The surgeon performs the decompression either from the front of the neck (anterior) or the back (posterior).
Each approach has its advantages and disadvantages. The spinal surgeon should choose the better approach on a per patient basis.
Who may need an Anterior Cervical Corpectomy?
Patients suffering from degenerative disease of the cervical spine may require an anterior cervical corpectomy. After degenerative damage or injury to the spine, bone spurs and herniated discs may form. With the addition of bone spurs or herniated discs, the space within the spinal canal decreases. When the space of the spinal canal decreases, spinal surgeons refer to the condition using the term spinal stenosis. Symptoms of spinal stenosis include:
- Difficulty walking
- Severe pain in the back or radiating throughout the body
- Numbness and weakness within the limbs
- Loss of bladder and/or bowel control
- Poor motor skills
To diagnose spinal stenosis or something causing a narrowing within the spinal canal, the spinal physician often starts with performing a physical examination. At the physical examination, the doctor also orders diagnostic testing. The testing may include Xray, MRI, CT Scan or other forms of diagnostics.
How do surgeons perform an Anterior Cervical Corpectomy?
Surgeons perform an Anterior Cervical Corpectomy under general anesthesia. Under general anesthesia, the patient remains fully asleep for the entirety of the procedure. While asleep, the patient cannot feel anything. The surgeon starts the procedure with an incision on the front aspect of the neck, typically in an existing neck fold. This hides the incision and makes the scar relatively undetectable. Once inside the neck, the surgeon removes the vertebra and replaces it with bone graft material.
In some cases, both disc and bone may press on the spinal cord. In these situations, the orthopedic spinal surgeon may perform a combination of discectomy and corpectomy.
Removing a disk or vertebra requires stabilizing the spine through fusion. Spinal fusion involves fusing vertebra together so that they heal into a single solid bone. Fusing the spine takes away some spinal flexibility which typically takes away a great deal of the pain associated with spine movement. The degree of limitation depends upon the amount of spine segments or “levels” involved.
In addition to fusion, surgeons often use metal plates and screws to help keep the bones in place. Spinal surgeons may use a variety of implants depending on the exact procedures performed, the patients injury, and the surgeons preference. Spine surgeons often use strut grafts or cages.