A Patient’s Guide to
A P
Cervical Corpectomy and Strut Graft
Montana Spine & Pain Center
500 W. Broadway
3rd Floor
Missoula, MT 59802
Phone: 406-327-1670 Fax: 406-329-5697
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Montana Spine & Pain Center
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The Staff of the Montana Spine & Pain Center.
Montana Spine & Pain Center 500 W. Broadway 3rd Floor
Missoula, MT 59802
Phone: 406-327-1670 Fax:
Introduction
A corpectomy is surgery to relieve pressure
on the spinal cord due to spinal stenosis
. In spinal stenosis华南理工大学就业
, bone spurs press against the spinal cord, leading to a condition called myelopathy . This can produce problems with the bowels and bladder and disrupt the way you walk. Fine motor skills of the hand may also be impaired. In a corpectomy, the front part of the spinal column is removed. (Corpus means body, and ectomy means remove.) Bone grafts are ud to fill in the space. This procedure is ud when bone spurs have developed in more than one vertebra.
This guide will help you understand • what part of the spinal column is affected
• why the procedure becomes necessary • what happens before and during the operation
• what to expect as you recover Anatomy
What parts of the neck are involved? Surgeons perform this surgery through the front of the neck . This is known as the neck region. Key structures include
ior ne anterior ligaments, bones, intervertebral discs, the spinal cord opening and spinal nerves.
Rationale
What do surgeons hope to achieve?
Spinal stenosis
occurs when bone spurs project into the spinal column and press against the spinal cord. Removing the vertebral bodies along the front ction of the spinal column gives surgeons a way to relieve
pressure on the front surface of the spinal cord, reducing or eliminating the symptoms caud by the bone spurs.Preparations
How will I prepare for surgery?
The decision to proceed with surgery must be made jointly by you and your surgeon. You should und
erstand as much about the procedure as possible. If you have concerns or questions, you should talk to your surgeon.Once you decide on surgery, you need to take veral steps. Your surgeon may suggest a complete physical examination by your regular
Front part of the neck忘记拥抱歌词
doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.
On the day of your surgery, you will probably be admitted to the hospital early in the
morning. You shouldn't eat or drink anything after midnight the night before. Surgical Procedure
What happens during the operation? Patients are given a general anesthesia to put them to sleep during most spine surgeries. As you sleep, your breathing may be assisted with a ventilator . A ventilator is a device that controls and monitors the flow of air to the lungs.
The surgeon starts by making an incision up the left side of the neck to the ear and then under the jaw to the bottom of the chin. The skin flap is opened to expo the structures of the neck. Retractors are ud to parate and hold the muscles and soft tissues apart so the surgeon can work on the front of the spine.Special instruments are attached either to the skull or the spinal bones to stretch the neck with mild traction. The traction pull spreads the neck joints apart to give the surgeon more room to work. It also takes additional pressure off the spinal cord. Then the surgeon inrts a needle into the disc and does an X-ray to locate the exact ctions where the bones are to be removed.
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The surgeon carefully cuts part of the anterior away from the front aw longitudinal ligament ction of the spinal column. Instruments are then ud to take out the front half of the discs that lie between the vertebral bodies. Next, a small rotary cutting tool (a ) is ud to ) is burr carefully remove the back half of the discs (called discectomy ) and a row of vertebral bodies (called corpectomy ). The ring of bone that surrounds and protects the spinal column isn't touched.
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When the discs and vertebral bodies are out of the way, the posterior longitudinal ligament can be en where it covers the front of the spinal cord. This thin ligament is shaved to remove areas that have hardened or buckled, as the areas are known to add pressure to the spinal cord.
The surgeon then prepares a that tha bone graft will fill in the space where the discs and verte-bral bodies have been removed. A ction of bone is taken from the fibula , the thin bone that runs along the outside of the lower leg. (The main bone of the lower leg is called the tibia .) Some surgeons prefer to take bone from the pelvis instead of the fibula.
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Before inrting the bone graft , the surgeon increas the traction pull on the neck to help parate the space even more. The bone graft is sized to fill the full length of the removed ction of bone and discs from one end to the other.
桃花的唯美句子The ction of bone is grafted into the space where the vertebral bones have been taken out. The graft acts like a supportive column, or strut, to support the elongated space and to prevent the neck from buckling forward. Your surgeon may attach a metal plate along the front of the spine to help lock the new graft in place.
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Another X-ray is taken to check the position of the graft. Then the muscles and soft tissues are put back in place, and the skin is stitched together. Patients are often placed in a rigid neck brace for at least three months to hold the neck still while the bones grow together, or fus
fu .Complications What might go wrong?
As with all major surgical procedures, compli-cations can occur. Some of the most common complications following corpectomy surgery include
• problems with anesthesia • thrombophlebitis • infection
• nerve damage
• problems with the graft or hardware • nonunion • ongoing pain
This is not intended to be a complete list of the possible complications, but the are the most common.
Problems with Anesthesia
Problems can ari when the anesthesia given
during surgery caus a reaction with other drugs. Patients can also have problems with the anesthesia itlf. In addition, anesthesia can affect lung function becau the lungs don't expand as well while a person is under anesthesia. Be sure to discuss the risks and your concerns with your anesthesiologist.
Thrombophlebitis (Blood Clots)
Thrombophlebitis , sometimes called deep venous thrombosis (DVT), can occur after any operation. It occurs when the blood in the large veins of the leg forms blood clots. This may cau the leg to sw
ell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they lodge in the capillaries and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism . (Pulmonary means lung, and embolism refers to a fragment of something traveling through the vascular system.) Most surgeons take preventing DVT very riously. There are many ways to reduce the risk of DVT, but probably the most effec-tive is getting you moving as soon as possible. Two other commonly ud preventative measures include
• pressure stockings to keep the blood in the legs moving
• medications that thin the blood and prevent blood clots from forming
Infection
Infection following spine surgery is rare but can be a very rious complication. Some infections may show up very early, even
before you leave the hospital. Infections on the
