An anterior lumbar corpectomy and fusion is a surgical procedure in which vertebral bone and intervertebral disc material is removed to relieve pressure on the spinal cord and spinal nerves (decompression) in the lumbar spine, or lower back.
What Is An Anterior Lumbar Corpectomy And Fusion?
The term corpectomy is derived from the Latin words corpus (body) and -ectomy (removal). The procedure typically involves accessing the spine through an anterolateral (flank or side of the body incision through the abdominal region) approach. Spinal fusion is usually necessary because of the amount of vertebral bone and disc material that must be removed to achieve sufficient decompression of the neural structures.
Spinal fusion involves placing bone graft or bone graft substitute between two or more affected vertebrae to promote bone growth between the vertebral bodies. The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.
Why Do I Need This Procedure?
Nerve compression in the lower back can cause back pain and/or pain, numbness and weakness that extends into the hips, buttocks and legs.
Degenerative spinal conditions, including herniated discs and bone spurs, are common causes of spinal nerve compression. Spinal fracture, tumor or infection also may result in pressure on the spinal nerves.
To determine whether your condition requires treatment with an anterior lumbar corpectomy and fusion, your doctor will examine your back and your medical history, and may order an x-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of your spine. An anterior lumbar corpectomy and fusion is typically recommended only after conservative treatment methods fail. Your surgeon will take a number of factors into consideration before making this recommendation, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. Please discuss this treatment option thoroughly with your spinal care provider.
How Is A Lumbar Corpectomy Performed?
Through an incision made in the side of your abdomen, your surgeon will:
- Remove a portion of the vertebral body(ies) and intervertebral disc(s) to access the compressed neural structures
- Relieve the pressure by removing the source of the compression
- Place a bone graft or bone graft substitute between the adjacent vertebrae at the decompression site
- Attach/implant instrumentation – rods, plates and screws – along the treated vertebra(e) to provide extra support and stability while fusion and healing occurs.
The primary advantage of performing the procedure using an anterolateral approach rather than a posterior (from the back) approach is that it offers a much wider exposure to the bone and disc material that is causing the pressure, which can then be removed without having to retract the spinal cord and neurologic structures, thus reducing the chance of neural injury.
Patients with a severe spinal problem or instability may also require a posterior spinal fusion with instrumentation in addition to an anterior corpectomy and fusion. If necessary, the second surgery is typically performed in a staged fashion several days after the initial corpectomy/fusion procedure.
Anterior corpectomy and fusion also can be performed in the thoracic (chest) region or thoracolumbar (lower chest/mid-back) region, depending on where the neurologic compression is located.
How Long Will It Take Me To Recover?
Your surgeon will have a specific postoperative recovery/exercise plan to help you return to your normal activity level as soon as possible. Following an anterior lumbar corpectomy and fusion, you may notice an immediate improvement of some or all of your symptoms; other symptoms may improve more gradually.
The amount of time that you have to stay in the hospital will depend on this treatment plan. You typically will be up and walking in the hospital by the end of the first day after the surgery. How quickly you return to work and your normal activities will depend on how well your body heals and the type of work/activity level you plan to return to.
Work closely with your spinal surgeon to determine the appropriate recovery protocol for you, and follow his or her instructions to optimize the healing process.
To determine whether you are a candidate for an anterior lumbar corpectomy and fusion, please talk to your doctor.
Are There Any Potential Risks Or Complications?
All treatment and outcome results are specific to the individual patient. Results may vary. Complications such as infection, nerve damage, blood clots, blood loss and bowel and bladder problems, along with complications associated with anesthesia, are some of the potential risks of spinal surgery. A potential risk inherent to spinal fusion is failure of the vertebral bone and graft to properly fuse, a condition that may require additional surgery.
Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to the lumbar corpectomy and fusion procedure.