Anterior Cervical Corpectomy Spine Surgery

A cervical corpectomy is surgery to remove damaged vertebrae and discs from the spine to relieve pressure on the spinal cord and nerves.

A corpectomy is typically performed when a discectomy is not sufficient to treat the problem.

A discectomy only removes protruding portions of a disc and possibly some associated bone spurs, while a corpectomy removes a vertebral body along with the discs above and below in order to decompress the spinal cord and affected nerve roots.

The term "anterior cervical corpectomy" is a combination of the words:

• Anterior – the surgery is done through the front of the neck
• Cervical –the cervical portion of the spine (neck)
• Corpectomy – a combination of the Latin words “corpus”, which means “body” and in this case refers to the vertebral body, and “ectomy”, which means removal (of the vertebral body)

A spinal fusion is done at the same time as the corpectomy, as the fusion is needed to reconstruct the spinal column after the removal of the discs and vertebral body (or bodies).

6 Key Points about Cervical Corpectomy and Fusion

Here are the key points you need to know if you are considering this type of procedure:

1. A cervical corpectomy with a spinal fusion is considered a major surgery.
2. It is a combination of two surgeries done at the same time: decompression to relieve symptoms, and cervical fusion to restore strength and stability.
3. The surgery is designed to relieve symptoms by decompressing the spinal cord and nerve roots, stabilizing the area of the spine, and relieving pain and neurological deficits.
4. Patients will often stay only one night in the hospital and go home the next day.
5. It is a technically difficult surgery and is usually done by a spine surgeon who specializes in this type of surgery.
6. Prior to the surgery, a patient will have typically tried/failed a series of nonoperative treatments and/or have a compelling neurologic issue.

Surgery is only considered if the nonoperative treatments have not provided meaningful symptom relief and/or if the symptoms involve the spinal cord and are progressing.

Medical Conditions Treated by Cervical Corpectomy

A cervical corpectomy is usually done for:

• Cervical stenosis that is present at more than one cervical motion segment, for example a cervical corpectomy may be done at the C5-C6 and C6-C7 segments (a C5 through C7 corpectomy), or at the C4-C5 and C5-C6 segments (a C4 through C6 corpectomy).
• Spinal cord compression (myelopathy) caused by extensive bone spur (osteophyte) growth, or other compressive pathology located behind the vertebral body.

Other conditions that a corpectomy may be done for include:

• Certain malignant spinal tumors, such as a chondrosarcoma or a chordoma
• Some benign tumors in the spine, such as a giant cell tumor
• Degenerative spinal conditions if they impinge on the spinal cord
• A major trauma, such as spine injury from a motor vehicle accident

The surgery may be done for the above conditions if one or more of the following symptoms are present:

• The patient’s symptoms do not respond to a concerted effort of nonsurgical treatments (such as pain medication, physical therapy, epidural steroid injections)
• The pain is severe and impedes the patient’s ability to function in everyday activities
• There is functionally significant and/or progressive neurological impairment, such as numbness or weakness in the legs and arms
• Any loss of ability to control the bladder and/or bowels caused by spinal cord compression
• Difficulty with the balance and coordination required for walking
• Difficulty with coordinating hand movement, such as while buttoning a shirt or tying shoelaces

The corpectomy is reserved for cases in which the spinal cord is significantly affected.

Cervical Corpectomy vs Alternative Surgeries

For most people who have anterior neck surgery, an ACDF (anterior cervical discectomy with fusion) is done.

ACDF is a more straightforward surgery that only involves removing the cervical disc and enough bone to decompress the nerves, followed by fusion.

The main difference between an ACDF and Cervical Corpectomy is that the ACDF does not involve removing the entire body of the vertebra and adjacent discs.

See Anterior Cervical Discectomy and Fusion Complications

In some cases, an alternative to ACDF is cervical artificial disc replacement, a surgery in which the disc is removed and replaced with an artificial disc.

Watch Cervical Disc Replacement Surgery Video

Spinal cord compression may also be treated by surgery done from the back of the neck (posterior decompression). This is usually indicated for spinal cord compression at three or more-disc levels (e.g. C2 – C5).

There are two generally applicable options for decompression, which depend on various clinical details: Laminoplasty or Laminectomy and fusion.

• Laminoplasty: this surgery re-shapes the roof of the spinal canal and preserves range of motion.
• Laminectomy and fusion. This surgery involves doing a cervical laminectomy in addition to a cervical fusion.