A Lumbar Corpectomy is a procedure to remove the vertebral body portion of the spinal segment.

The vertebral body is the bony portion between the discs that sits in front of the spinal canal. This is often done for fracture and tumor treatment. Sometimes there is nerve or spinal cord compression with fractures and tumors and this type of procedure can be very effective at decompressing those structures. A bone graft with or without a metal plate and screws is used to reconstruct the spine and provide stability.

You will need a complete physical exam to be sure you are in good health. A blood test, electrocardiogram (EKG), and chest X-ray need to be performed. Discuss all medications (prescription, over-the-counter, and herbal supplements) you are taking with your health care provider. Some medications need to be continued or stopped the day of surgery.

Medications that thin the blood should be stopped prior to surgery. Your Internist or primary doctor should be consulted prior to changing or discontinuing any medications. Also, stop drinking alcohol 1 week before and 2 weeks after surgery because these activities can cause bleeding problems. An important thing you can do to ensure the success of your spinal surgery is to quit smoking. This includes cigarettes, cigars, pipes, chewing tobacco, and smokeless tobacco. Nicotine prevents bone growth and puts you at higher risk for a failed fusion.

Morning of surgery

  • Shower using antibacterial soap. Dress in freshly washed, loose-fitting clothing.
  • Wear flat-heeled shoes with closed backs.
  • If you have instructions to take regular medication the morning of surgery, do so with small sips of water.
  • Remove make-up, hairpins, contacts, body piercings, nail polish, etc.
  • Leave all valuables and jewelry at home (including wedding bands).
  • Bring a list of medications (prescriptions, over-the-counter, and herbal supplements) with dosages and the times of day usually taken.
  • If you have a cold, fever or some other illness the day before surgery, please call your surgeons office.
  • Bring a list of allergies to medication or foods.

During the operation, you are positioned on your back. An incision will be made somewhere on the abdomen with location determined by the region of the lumbar spine requiring surgery. The size of this incision will depend on the extent of your problem. The middle portion of the vertebrae is removed, relieving pressure on the nerve root(s) and/or spinal cord. The diseased or damaged vertebrae discs above and below the vertebrae involved are also removed. Once the vertebral body has been removed, it means that the surgeon must fill the space left with a block of bone or bone graft placed into a biomechanical cage type of device. The cage is typically made of metal alloy, carbon fiber or polymer. Placing a bone graft or cage in the empty space holds the remaining vertebrae apart. Over time the bone is fused into the remaining vertebrae so that the bones involved become 1. A small metal plate is often affixed to the vertebrae with screws, to impart immediate stability to the construct (much like an internal cast) and allow for optimal bone healing and fusion. X-rays are then used to confirm appropriate position and alignment of the graft and hardware. The surgery takes approximately 2-3 hours.

Most patients are able to go home 2-4 days after surgery. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending and twisting of the back and heavy lifting during the first 4-6 weeks. Patients can gradually begin to bend and twist their back after 6-8 weeks as the pain subsides and the back muscles get stronger. Most patients are provided with a structural brace to wear that decreases bending and twisting and protects your spine as you heal.

There are also some significant lifting restrictions that patients have for the first several months following surgery. As therapy progresses and there is evidence of fusion on Xrays obtained during follow-up appointments with your surgeon, lifting restrictions will be lightened and you will be allowed to do more activities.

The surgery serves to improve pain and function and prevent further neurologic deterioration and paralysis. The fusion rate is significantly improved with the use of plates, rods and/or screws. Braces are commonly ordered to be worn after surgery to add stability and prevent you from too much bending. Most patients are noted to have gradual improvement of their pain and function following surgery.