Cervical Corpectomy and Strut Graft
Table of Contents
Introduction
Many cervical problems are due to degenerative changes that occur in the discs and joints of the neck. These changes commonly take place as a natural part of aging and from the effects of daily wear and tear on the parts of the spine. Degenerative changes in the neck sometimes lead to a serious condition where pressure is put on the spinal cord. One surgical option to relieve the pressure is to remove the degenerative vertebrae and replace them with bone graft. This procedure is called a corpectomy and strut graft.
Learn about cervical corpectomy and strut graft including
- How the cervical spine is affected?
- Why the procedure is performed?
- What you can expect from this procedure including possible complications?
Anatomy
To understand your symptoms and treatment choices, it is helpful to start with a basic understanding of the anatomy of the neck. This includes becoming familiar with the various parts that make up the cervical spine and how they work together.
Rationale
An effective procedure for removing the pressure on the spinal cord due to spinal stenosis is to remove one or several vertebral bodies to take pressure off the spinal cord. The procedure is called a corpectomy. Corpus means "body" and ectomy means "remove." The discs between the vertebrae are also removed.
After removal of the vertebral body (or bodies), a cervical fusion is performed. When the bodies of one or more vertebrae are taken out, a bone graft is inserted to fill the space. As the bone graft heals, it fuses to the intact vertebrae above and below it. The bone graft provides structural support to the cervical spine.
Procedure
In the cervical corpectomy procedure, the vertebrae are removed from the front. An incision is made in the front of the neck beside the trachea (windpipe). The muscles are moved to the side. The arteries and nerves in the neck are also protected.
Upon reaching the front of the spine, the surgeon uses an X-ray to identify the correct vertebrae and discs. The vertebral bodies and discs causing problems are removed all the way back to the spinal cord. Bone spurs that extend from the back of the vertebrae toward the spinal canal are removed as well. Special care is taken to reduce the risk of damaging the spinal cord and nerve roots.
Once the vertebrae and discs have been removed, the space between the vertebrae above and below must be filled. Doctors typically implant a graft of bone into the space. The section of bone graft works like a "strut" to support the spine. The strut may be formed by taking bone from your hip (pelvis) or from the fibula bone in your leg. Bone taken from your own body is called autograft. Your surgeon may also use allograft, which is bone taken from a source other than your body and stored in a bone bank.
Some method of internal fixation to hold the bones and bone graft in place is normally used. The most common method is to use metal (titanium) plates and screws. The plate sits on the front of the remaining vertebrae, covering the strut graft. Screws are placed into the vertebral bodies above and below the graft to hold the plate in place and keep the bone graft from slipping.
Complications
Like all surgical procedures, operations on the neck may have complications. Because the surgeon is operating around the spinal cord, neck operations are always considered extremely delicate and potentially dangerous. Take time to review the risks associated with cervical spine surgery with your doctor. Make sure you are comfortable with both the risks and the benefits of the procedure planned for your treatment.
Rehabilitation
This is a serious and complex operation. Patients usually wear a neck brace after surgery. Some patients may need the extra support of a halo brace. Most patients do not require rehabilitation after this surgery. However, a short period may be needed for patients who are having pain or difficulty doing routine activities. A physical therapist may work with you to design a specific exercise program.
Once the fusion is healed, you may progress toward a more vigorous rehabilitation program.
