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Vertebral body resection | Vertebral Column Resection

Vertebral Body Resection

Vertebral Body Resection | Vertebral Column Resection

Vertebral Body Resection, also known as Corpectomy or Vertebrectomy, is a surgical procedure that minimises spinal cord and nerve pressure by removing all or part of the vertebral body.

Pre-procedure: Diagnostic examinations like computed tomography (CT) or magnetic resonance imaging (MRI) scans are conducted based on symptoms and medical history to locate the affected region. You will be given personalised instructions regarding fasting, medications to avoid, and other general instructions to follow.

Procedure: The procedure is conducted by making an incision in the front (Anterior Corpectomy), or back (Posterior Corpectomy), based on aetiology and patient factors. Anaesthesia is administered before the surgery to numb the pain and put the patient to sleep to mitigate any discomfort. An incision can also be made on either side of the neck to reach the cervical spine (Cervical Corpectomy). With the help of X-ray guidance like Fluoroscopy, the whole or affected vertebral portion is removed to relieve any pressure. The specialist then inserts a bone graft, mostly made of titanium cages, to ensure proper size and placement. Plates and screws are inserted to stabilise the neck and implants. The incisions are later closed with absorbable sutures.

Post-procedure: You will be transferred to the recovery room for further observation.

FAQ's

Conditions that may require a Vertebral Body Resection procedure include:

  • Compressive myelopathy or spinal cord compression, leading to neurological symptoms
  • Abnormal bone growth referred to as retro vertebral hypertrophic osteoarthritis
  • Spinal stenosis or narrowing of the spine
  • Infections like osteomyelitis
  • Tumours of benign, early, and advanced
  • Radiculopathy
  • When conventional treatments fail
  • Trauma
  • Herniated disk and pinched nerves

Some signs and symptoms that may necessitate a Vertebral Body Resection procedure include:

  • Weakness
  • Numbness or tingling feeling in the lower regions of the spine
  • Discomfort or tightness in the back or neck
  • Sciatica
  • Loss of function of hand motor skills
  • Stumbling
  • Uncontrolled bowel and bladder

While addressing symptoms is important, the primary goal is to target the root cause of compression and nerve root impact.

Our specialists will provide personalised instructions for you to prepare for the procedure. General instructions, however, include:

  • Write down your questions, concerns, or worries that you would like to share with our specialist

  • Inform our specialist if you are pregnant and consuming any medications

  • Let our doctors know if you have any past allergies induced by anaesthesia or sedatives, food, medications, or latex

  • Removing any polished nails and not wearing any makeup

  • Leaving any metallic objects or jewellery 

  • Bringing your pillow and other comfort items for your hospital stay post-procedure

  • Planning your transportation to and from the hospital

  • Abstaining from smoking or using tobacco products

  • Taking medications prescribed by your specialist before surgery, and avoiding medications such as blood thinners

Some potential risks or complications associated with Vertebral Body Resection include:

  • Hoarseness or difficulty swallowing in case of Cervical Vertebral Body Resection
  • Post-operative infections
  • Failed fusion
  • Implantation failure due to migration or dislodging, requiring revision surgery
  • Blood clots
  • Nerve injury
  • Spinal cord damage
  • Dural tear, leading to leakage of cerebrospinal fluid

Iatrogenic vertebral artery injury, leading to stroke and excessive bleeding

The length of your hospital stay can vary depending on factors such as the occurrence of post-surgical complications and other individual factors. Generally, patients remain in the hospital for approximately 1 to 3 days following surgery. During your stay, you will be monitored closely and will be encouraged to perform activities such as walking, sitting, and using the bathroom. Our specialists will also prescribe pain medications to manage post-operative pain, recommend braces or other equipment, and provide advice regarding post-care instructions.

The recovery period may vary based on individual factors. However, it may take 6 months or more for patients who have undergone Vertebral Body Resection. If the procedure involves the neck (Cervical Corpectomy), wearing a neck brace for several weeks will be recommended to stabilise your neck. You may need assistance to perform certain activities for 1-2 months. Shorter, periodic walks will be recommended to prevent any complications related to activity. Additionally, you can return to work after about 12 weeks and resume driving within two to three weeks. You will also be instructed to perform particular exercises advised by our physical and occupational therapists to enhance your recovery.

General instructions that you should follow after undergoing a Vertebral Body Resection procedure include:

  • Adhering to post-operative pain medications as prescribed by our specialist

  • Attending follow-up appointments scheduled by our specialist to monitor your progress

  • Quitting smoking or chewing tobacco

  • In the case of Cervical Vertebral Body Resection, avoid straining your voice and excessive neck movement. Moreover, wear a cervical collar as instructed by our specialist

  • Shower as directed by our specialist. However, keep your incisions clean and free from moisture

  • Consuming dietary fibre and staying hydrated to manage constipation

  • Refraining from driving for a certain period of time or until our specialist gives you a green light

  • Performing exercises instructed by our physical and occupational therapists and avoiding strenuous activities such as pushing or pulling heavy objects and lifting

  • Abstaining from sitting for prolonged periods with a bent spine. It is essential to keep your spine straight

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