Cervical Corpectomy and Strut Graft
What are cervical corpectomy and strut graft?
Many cervical problems are due to degenerative changes that occur in the discs and joints of the neck. Degenerative changes in the neck sometimes lead to a serious condition where pressure is put on the spinal cord. One surgical option to relieve the pressure is to remove the degenerative vertebrae and replace them with bone graft. This procedure is called a corpectomy and strut graft (corpus means “body” and ectomy means “remove”).
How cervical corpectomy and strut graft works
In the cervical corpectomy procedure, the vertebrae are removed from the front. An incision is made in the front of the neck beside the trachea (windpipe). The muscles are moved to the side. The arteries and nerves in the neck are also protected.
Upon reaching the front of the spine, the surgeon uses an X-ray to identify the correct vertebrae and discs. The vertebral bodies and discs causing problems are removed all the way back to the spinal cord. Bone spurs that extend from the back of the vertebrae toward the spinal canal are removed as well. Special care is taken to reduce the risk of damaging the spinal cord and nerve roots.
Once the vertebrae and discs have been removed, the space between the vertebrae above and below must be filled. Doctors typically implant a graft of bone into space. The section of bone graft works like a “strut” to support the spine. The strut may be formed by taking bone from your hip (pelvis) or from the fibula bone in your leg.
Some method of internal fixation to hold the bones and bone graft in place is normally used. The most common method is to use metal (titanium) plates and screws. The plate sits on the front of the remaining vertebrae, covering the strut graft. Screws are placed into the vertebral bodies above and below the graft to hold the plate in place and keep the bone graft from slipping.
Are there risks?
Like all surgical procedures, operations on the neck have risks. Because the surgeon is operating around the spinal cord, neck operations are always considered extremely delicate and potentially dangerous. Take time to review the risks associated with cervical spine surgery with your doctor. Make sure you are comfortable with both the risks and the benefits of the procedure planned for your treatment.
What happens after surgery?
This is a serious and complex operation. Patients usually wear a neck brace after surgery. Some patients may need the extra support of a halo brace.
Most patients do not require rehabilitation after this surgery. However, a short period may be needed for patients who are having pain or difficulty doing routine activities. A physical therapist may work with you to design a specific exercise program. Once the fusion is healed, you may progress toward a more vigorous rehabilitation program.