Corpectomy Benefits – Benefits of Neck Surgery
Anterior corpectomy with fusion is advantageous compared to anterior cervical discectomy with fusion as it can facilitate wider decompression across multiple levels, more successfully remove pathological structures, and has fewer points required for fusion to succeed (Sevki, 2004). Patients with severe cervical canal stenosis or anterior spine pathology have a higher chance of success at relieving neurological pain, axial neck pain, and preventing the risk of alignment problems after surgery with this procedure than with ACDF, laminectomy, or laminoplasty (Yonenobu, 1985, 1992; Wada, 2001).
Multiple Level Neck Surgery
If the surgery involves three or more levels of the cervical spine then the risk of graft-host complications increases. This can include problems such and graft dislodgement, spinal cord compression and unsuccessful fusion (pseudoarthrosis). However, operations on the anterior cervical spine tend to have higher success rates for fusion than on the posterior spine using both allograft or autograft techniques as there is compression in this area rather then tension. Acosta (2008) found no relation between sagittal balance improvements and the number of levels of the spine operated on, with the use of a titanium mesh cage. Indeed, a six-level corpectomy on a patient with severe stenosis of the cervical spine has been conducted successfully, with good follow-up indications (Acosta, 2006).
Corpectomy Outcome Data
In a review of 261 patients undergoing a corpectomy Mayr (2002) observed successful fusion in 86.6% of patients, with a stable, fibrous union developing in a further 12.6%, and only an unstable pseudoarthrosis occurring in two patients (0.8%) with re-operation required. No infection, spinal fluid leakage, or postoperative haematoma occurred in any of these patients, giving a corpectomy an improved and excellent record for safety and low risk in comparison to some other procedures on the cervical spine. A corpectomy can successfully relieve severe stenosis of the cervical spine, alleviating myelopathy, radicular pain, neck pain, stiffness, problems with mobility and fine motor skill, numbness, weakness, and paraesthesia. The extent of the recovery depends on the pre-operative intractability of degeneration, with outcome positively influenced by following the surgeon’s guidelines including stopping smoking, wearing the hard cervical collar, and avoiding putting strain on the neck area.