Corpectomy

Corpectomy (followed by fusion) refers to the removal of one or more vertebral bodies to treat compressive myelopathy caused by extensive hypertrophic osteoarthritis, tumour, infection or severe trauma. In most cases, the intervertebral discs are removed as well 1-3

Technique

An anterior or posterior approach may be utilised.

Once the vertebral body is resected a spinal fusion must be carried out, and a number of alternatives exist depending on location, aetiology of underlying pathology, surgeon preference and prognosis. 

A bone graft is often used to fill the space and eventually lead to complete osseous fusion 1. An autograft from the patient's pelvic bones (most commonly, the iliac wing) or lower limb bones (most commonly, the fibula) can be used. Alternatively, a mechanical construct can be inserted (e.g. titanium cage) or expandable device 1-3. Following this additional instrumentation is required to fully stabilize the segment. 

Less commonly, bilateral stabilising decompression rods are applied, without filling the post-corpectomy gap.

Complications

  • neurological deficits 2
  • dural tear with CSF leak
  • wound infection
  • graft displacement
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