Complex Spine Surgery

Anterior Lumbar Corpectomy and Fusion

An Anterior Lumbar Corpectomy and Fusion is a surgical technique that is performed to remove the vertebral bone or disc material to alleviate pressure on the spinal cord and spinal nerves (decompression) in the lumbar region, or lower back.

What is the Anterior Lumbar Corpectomy and Fusion surgical approach?

The term corpectomy originates from the Latin word ‘corpus’ which means ‘body’ and the word ‘ectomy’ means ‘removal’. The procedure typically involves accessibility of the spine through an anterolateral approach, an incision in the flank or side of the abdominal region. Spinal fusion is essential after the removal of vertebral bone and disc material to relieve the compression over the neural structure.

In the procedure of spinal fusion, bone graft or bone graft substitute can be used between two or more affected vertebrae. The graft material binds the two vertebrae together and promotes bone healing, stabilizes the spine and helps to preserve the normal disc height as the body heals and bone and bone graft grow together to join the vertebrae.

What is the necessity of Anterior Lumbar Corpectomy and Fusion surgery?

Any degenerative spinal conditions such as herniated discs or bone spurs are the most common causes of spinal nerve compression. Spinal fracture, tumor or any infection also may cause pressure on the spinal nerves.
Nerve compression in the lower back usually leads to back pain, numbness or weakness extending into the hips, buttocks and legs.

To diagnose the requirement for anterior lumbar corpectomy and fusion, the physician may inspect your back and medical history and may ask for an X-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of your spine for a better view. When non-surgical treatment options fail to reduce the symptoms, then anterior lumbar corpectomy and fusion can be recommended.

Before recommending the surgery your surgeon considers various factors such as the condition to be treated, your age, health, lifestyle and your expected level of activity after the surgery. Before initiating the treatment discuss with your spinal care provider regarding the treatment options.

What is the procedure for Anterior Lumbar Corpectomy and Fusion surgery?

In the procedure of Lumbar Corpectomy the surgeon makes an incision in the side of the abdomen and removes a portion of vertebral body and intervertebral disc to access the involved neural structure. The source of compression is removed and the compressed nerves released. Bone graft or bone graft substitute is inserted between the contiguous vertebrae at the decompression site and instruments such as rods, plates and screws are fixed to thein the treated vertebra(e) to deliver additional support and stability during fusion and healing of the bone.

The major advantage of anterolateral approach rather than a posterior approach is much wider exposure to the bone and disc material that is causing pressure over the neural structure which can be removed without retracting the spinal cord and neurologic structures. Therefore it reduces the tendency of neural injury.

Sometime a posterior spinal fusion with instrumentation in addition to an anterior corpectomy and fusion is recommended for patients with a severe spinal problem or instability. If required, several days after the initial corpectomy/fusion procedure, the second surgery can be performed in a staged manner.

Depending on the location of the neurological compression, anterior corpectomy and fusion can be executed in the thoracic (chest) region or thoracolumbar (lower chest/mid-back) region.

What is the recovery period for Anterior Lumbar Corpectomy and Fusion surgery?

After surgery each patient has their definite post-operative rehabilitation plan that helps the patient to return to their normal active life as soon as possible. Following a Lumbar Corpectomy and Fusion, you may observe an immediate improvement of some or all symptoms or sometimes a gradual improvement of the symptoms also may be seen.
The amount of time of hospitalization mostly depends on the treatment plan. At the end of the first day of the surgery you are allowed to move and walk around the hospital. Returning back to your daily life or to work depends on how well you are healing and the type of work or activity level.

Follow your spinal surgeons instructions regarding the proper recovery program and instructions to augment the healing process for a successful recovery.

Discuss with your surgeon to determine if you are a candidate for Anterior Lumbar Corpectomy.

What are the risks or complications of Anterior Lumbar Corpectomy and Fusion?

Every patient has a particular treatment plan and outcome result which varies from individual to individual. The complications of Anterior Lumbar Corpectomy and Fusion include infection, nerve damage, blood clots, blood loss, bowel and bladder problems and any problem associated with anesthesia. The underlying risk of spinal fusion surgery is failure of fusion of vertebral bone and bone graft which usually requires an additional surgery.

Please refer to your physician to obtain a list of indications, adverse effects or precautions, clinical results and other significant medical information related to the Anterior Lumbar Corpectomy and Fusion.