Anterior Lumbar Corpectomy
A type of spinal decompression and fusion procedure, anterior lumbar corpectomy removes damaged vertebra and tissues that are pinching nerve roots. Bone graft or cage is inserted to stabilize the spine.
What is an Anterior Lumbar Corpectomy?
- Procedure to correct spinal deformities and to relieve pain from diseased or damaged vertebrae that are pinching spinal nerve roots. Resolves symptoms that failed to alleviate after attempting conservative methods of treatment.
- Decompresses the pinched spinal nerve(s) and/or the spinal cord. Removes the entire diseased vertebrae, the deteriorated vertebral discs above and below the vertebrae, and replaces all segments with a bone graft and/or cage. A small metal plate is attached to allow the graft to fuse with the vertebrae above and below it.
- During the procedure, the patient lies on their right side and the surgery is performed through their left.
Anterior lumbar corpectomy is a spinal procedure that decompresses spinal nerve roots and/or the spinal cord being pinched by a damaged vertebra. The procedure uses an anterolateral (through the abdominal region) approach to remove the bone and other tissues causing compression. This is unlike posterior approaches that approach from the back.
During an anterior lumbar corpectomy, the affected vertebra is partially or entirely removed, along with the two vertebral discs above and below the bone, and any other spinal abnormalities. For stability, a bone graft is inserted into the vertebral space to conjoin three vertebrae into one. It can be performed for any of the thoracic (middle back) and lumbar (lower back) vertebral discs. A corpectomy on a thoracic vertebra is called an anterior thoracic corpectomy.
This procedure is performed to help patients with a severe spinal condition, such as a diseased spinal fracture, a spinal tumor, or an infection. These conditions may invade the vertebral space and compress against the spinal nerves and/or the spinal cord, causing pain and other debilitating symptoms.
Some symptoms that an anterior lumbar corpectomy aims to treat include: chronic and/or severe pain that is sharp, dull, radiating, throbbing, or burning, weakness in the lower extremities, numbing or tingling sensation felt down the legs, and difficulty walking, sitting, or standing.
What does it treat?
- Fractured Vertebrae
- Degenerative Disc Disease
- Spinal Tumor
- Spinal Infection
Who are good candidates?
Ideal candidates for an anterior lumbar corpectomy may have different spinal conditions and varying symptoms. Patients should have chronic pain for at least 3 to 6 months, and should experience one or more of the following symptoms:
- Mild to severe chronic pain in the mid to low back that is dull, sharp, throbbing, shooting, and/or burning
- Pain that radiates from the middle back and into the ribs and chest or from the lower back and into the buttocks, legs, calves, feet, and toes
- Decreased motor skills, especially in the lower extremities
- Weakness, stiffness, or numbness felt in the lower extremities
- Difficulty walking, standing, or sitting for periods of time
- Inability to perform everyday activities
- Attempted multiple conservative methods of treatment that were unsuccessful in significantly relieving pain
Additionally, patients should be aware of any physical therapy that may be part of their recovery process and be optimistic towards successful pain management.
What is the procedure like?
During the procedure, patients will be under general anesthesia. The procedure takes between 1 to 3 hours to complete, depending on complexity.
The following are the general steps of an anterior lumbar corpectomy:
- The operation begins when the area of the patient's left side is prepped for the incision. Most often the bone graft will come from a bone bank; if the patient prefers their own bone, then the hip will be prepped for an incision. A titanium cage filled with bone graft can also be used to bridge the space between the vertebrae.
- After making a 1 to 5 inch incision (depends on the patient), the muscles and tissues are separated to access the diseased vertebra.
- The damaged parts of the vertebral bone are removed so the nerve roots can relax.
- The vertebral discs above and below the removed vertebra are also eliminated, along with any spinal abnormalities. The bone's surfaces are then cleaned to prepare for the bone graft. If applicable, the bone graft extraction will now occur.
- Two bolts are screwed into the above and below vertebrae. Then, tools are used to hook onto the bolts so the vertebral space can be opened. This corrects the spine's curvature.
- The bone graft or cage is inserted into the vertebral space. To aid in fusion, a small metal plate is attached to the two bolts, along with two additional screws.
- The procedure ends when the surgeon closes the incision with sutures.