Hertfordshire Spine Clinic Mr Sajjad Mushtaq

Cancer Surgery

Spinal Corpectomy

Cervical Corpectomy

An anterior cervical corpectomy and fusion is an operative procedure to relieve pressure on the spinal cord and spinal nerves by removing the damaged vertebral bone and/or intervertebral disc material (decompression) at the cervical spine, or neck.

What is anterior cervical corpectomy and fusion?

Anterior cervical corpectomy involves removing the vertebral bone or disc material by approaching the cervical spine from the front side (anterior position) of the neck. Spinal fusion implies placing a bone graft between the two affected vertebral bodies, encouraging bone growth between the vertebrae. Spinal fusion helps in achieving adequate decompression of the neural structures. The bone graft acts as a medium for binding the two vertebral bones, and grows as a single vertebra which stabilizes the spine. It also helps to maintain the normal disc height.

Who needs this surgery?

Degenerative spinal conditions like herniated discs and bone spurs results in spinal nerve compression. In addition, spinal fractures, infection or tumors may also put pressure on the spinal nerve structures. Nerve compression in the neck region (cervical spine) can cause neck pain and/or pain, weakness or numbness that radiates down to the arms. Your surgeon recommends you for anterior cervical corpectomy and fusion surgery after examining your spine, medical history, and imaging results of cervical vertebrae such as X-ray, CT (computed tomography) scan or MRI (magnetic resonance imaging). Surgery is recommended only after non-surgical treatment approaches fail. Before recommending surgery, your surgeon considers several factors such as your health condition, age, lifestyle and anticipated level of activity following surgery. A thorough discussion with your surgeon regarding this treatment option is advised before scheduling the surgery.

How is the procedure performed?

Your surgeon makes a small incision at the front of your neck to the side and locates the source of neural compression. Then, the vertebral body or intervertebral disc that is compressing the nerve root will be removed to relieve the compression. Afterwards, a bone graft will be placed at the site of decompression. In addition, instruments such as plates and screws are used to provide additional support and stability and to ease healing and fusion of the vertebrae.

How much time will it take for complete recovery?

A specific post-operative recovery/exercise plan will be given by your physician to help you return to normal activity at the earliest possible. After surgery, your symptoms may improve immediately or gradually over the course of time. The duration of hospital stay depends on this treatment plan. You will be able to wake up and walk by the end of the first day after the surgery. You should be able to resume your work within 3-6 weeks, depending on your body’s healing status and the type of work/activity that you plan to resume. Discuss with your spinal surgeon and follow their instructions for optimized healing and appropriate recovery after the procedure.

What are the possible risks or complications?

All surgeries carry risk and it is important to understand the risks of the procedure in order to make an informed decision to go ahead with the surgery. In addition to the anesthetic complications, spinal surgery is associated with some potential risks such as infection, blood loss, blood clots, nerve damage, and bowel and bladder problems. Failure to fuse the vertebral bones with the bone graft (fusion failure) is an important complication of spinal fusion which requires an additional surgery.

Please take your physician’s advice for a complete list of indications, clinical results, adverse effects, warnings and precautions, and other relevant medical information about the anterior cervical discectomy with fusion surgery.

Thoracic Corpectomy

What is thoracic corpectomy?

Thoracic corpectomy is a procedure performed to relieve pressure on a nerve at the thoracic region (upper and middle back) by removing the source of the compression.

Who needs this surgery?

It is indicated for conditions such as degenerative disc disease, spinal stenosis, bone spurs, tumor, fracture and infection leading to spinal compression, which cause pain, weakness and numbness in various parts of the body.

How is thoracic corpectomy performed?

Thoracic corpectomy is carried out under general anesthesia. You will lie on your side during the procedure. An oblique incision is made. Important organs are moved aside to protect them during the surgery. The surgery involves two stages – decompression and fusion. To decompress the nerve, the presence of bone spurs, tumors or fractures causing the compression are removed. This is followed by fusion, where deformed or diseased vertebrae are removed along with the intervertebral discs, and the adjacent vertebrae are then fused. A bone graft is placed in this region to provide stability and a metal plate with screws may be used to provide added support. The procedure typically takes 3-4 hours to complete. Following surgery, you will remain in the hospital for 2-3 days.

How long does recovery take?

You may notice immediate improvements in symptoms and may be able to walk the same day. Further improvement takes place over time. Your doctor will advise you when it is safe to return to work.

What are the possible risks or complications?

Risks and complications may be associated with this procedure, which is common to all spine surgeries. These include bleeding, infection and nerve damage.

Lumbar Corpectomy

What is anterior lumbar corpectomy and fusion?

Anterior Lumbar Corpectomy and Fusion is a surgical technique performed to remove the vertebral bone or disc material between the vertebrae to alleviate pressure on the spinal cord and spinal nerves (decompression) in the lumbar (low back) region.
The term corpectomy originates from the Latin word ‘corpus’ which means ‘body’ and the word ‘ectomy’ means ‘removal’. Spinal fusion is essential for spinal stability after the removal of vertebral bone and disc material to relieve the compression over the neural structure.

What are the causes of spinal nerve compression?

Common causes of spinal nerve compression are:

  • Degenerative spinal conditions such as herniated discs
  • Spinal fractures
  • Tumors
  • Infection

What are the symptoms associated with nerve compression?

Nerve compression in the lower back usually leads to back pain, numbness or weakness extending into the hips, buttocks and legs.

When is lumbar corpectomy indicated?

Anterior lumbar corpectomy and fusion is recommended when non-surgical treatment options fail to reduce the symptoms.
Before recommending surgery, the surgeon considers various factors such as age, condition to be treated, health, lifestyle, and the activity level of the patient.

How is the procedure performed?

For the procedure, the surgeon makes an incision in the side of the abdomen and retracts the soft tissues such as muscles to gain visibility to the spine. A portion of vertebral body and intervertebral disc is removed to access the involved neural structure. The source of compression is removed and the compressed nerves released. During the fusion of two adjacent vertebrae, bone graft or bone graft substitute is inserted between the vertebrae at the decompression site to promote healing and to preserve the normal disc height. Implant material such as rods, plates and screws are fixed to the treated vertebra (e) to deliver additional support and stability during the fusion and healing process. After the procedure, the surgeon realigns the soft tissues and closes the incision.

How long does recovery take?

The duration of hospitalization depends on the treatment rendered. At the end of the first day of the surgery you are allowed to move and walk around the hospital. Returning back to your daily life or to work depends on how well you are healing and the type of work or activity level.
Follow your spinal surgeon’s instructions regarding the proper recovery program and instructions to augment the healing process for a successful recovery.

When can I expect improvement in symptoms?

Following a Lumbar Corpectomy and Fusion, you may observe an immediate improvement of some or all symptoms or sometimes a gradual improvement of the symptoms also may be seen.

What are the possible risks or complications?

The possible complications of the surgery include infection, nerve damage, blood clots or blood loss or bowel and bladder problems and any problem associated with anesthesia. The underlying risk of spinal fusion surgery is failure of fusion of vertebral bone and bone graft which usually requires an additional surgery.

Talk to your spine surgeon if you have any concerns or queries regarding Anterior Lumbar Corpectomy and Fusion.

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