Cervical corpectomy is an operation to remove a portion of the vertebra and adjacent intervertebral discs for decompression of the cervical spinal cord and spinal nerves.

The vertebral body bone that is removed is typically saved and is the graft used to place into the cage device. The biomechanical cage or spacer is typically made of metal alloy, carbon fiber or polymer. The bone graft serves as a bridge between the two vertebrae to create a spinal fusion. A metal alloy plate and screws are typically but not always used to provide stability to the cage device.

One or more diagnostic studies such as magnetic resonance imaging (MRI) or a CT Scan and myelogram may be necessary to diagnose the degree of herniation and/or bone spurs affecting the nerves and/or spinal cord. This valuable information is used by Dr. Kube to understand your condition so that he may perform the procedure precisely. You should arrange to have someone drive you to and from the facility. You are not permitted to eat or drink after midnight the night before surgery.

Cigarette smoking dramatically impairs bone healing. So, if you smoke, smoking cessation will significantly improve the likelihood for a successful fusion. You should also stop taking any medications or vitamins that thin the blood. Consultation with your Internist or other treating physician regarding the cessation of the medication should occur before you discontinue any medication. They may also desire a variety of tests and labs to be done to help determine what medial risks you might have if surgery is to be performed.

Ask questions. We are here to provide you with as much information as possible so that you are able to make an informed decision and optimize outcomes and expectations.

  • Shower using antibacterial soap. Dress in freshly washed, loose-fitting clothing.
  • Wear flat-heeled shoes with closed backs.
  • If you have instructions to take regular medication the morning of surgery, do so with small sips of water.
  • Remove make-up, hairpins, contacts, body piercings, nail polish, etc.
  • Leave all valuables and jewelry at home (including wedding bands).
  • Bring a list of medications (prescriptions, over-the-counter, and herbal supplements) with dosages and the times of day usually taken.
  • If you have a cold, fever or some other illness the day before surgery, please call your surgeons office.
  • Bring a list of allergies to medication or foods.

During the operation, you are positioned on your back. An incision will be made on your neck; the size of this incision will depend on the extent of your problem. The discs above and below the vertebrae involved are removed. The middle portion of the vertebrae is removed, some of which is saved for use in the fusion. Special instruments are used to decompress the underlying spinal cord and nerve roots. Once the vertebral body which was pressing upon the nerves and/or spinal cord has been removed, the surgeon must stabilize the defect created with a block of bone or bone graft which was packed into a metal, carbon fiber or polymer cage. Placing a structural bone graft into the empty space holds the remaining vertebrae apart while the bone fuses together. The bone graft serves as a bridge between the two vertebrae to create a spinal fusion. A small metal plate is frequently placed, affixed to the vertebrae with small screws, to impart immediate stability to the construct and allow for optimal bone healing and fusion. X-rays are then used to confirm appropriate position and alignment of the graft and hardware.

The surgery takes approximately 2-3 hours plus added time for anesthesia and placement of nerve monitoring systems. A wound drain is usually placed which will typically be removed the following morning. The sutures used to close the wound dissolve on their own and do not need to be removed.

Most patients are able to go home the morning after surgery. The surgical drain is removed the morning after surgery. Before patients go home, physical therapists and occupational therapists generally work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending and twisting of the neck and heavy lifting during the first several weeks. Patients can gradually begin to bend and twist their neck as the pain subsides and the neck and back muscles get stronger.

Most patients are placed in a padded, plastic neck brace. This reduces the stress on the neck area and helps decrease pain. It can also be used to improve bone healing by maintaining the neck in a rigid position, especially in the first few weeks and months after surgery. Some patients will be provided and instructed in the use of a bone stimulator device to improve the bone healing rates.

The wound area can be left open to air. No bandages are required other than to protect clothing from any remaining wound drainage. Drainage typically stops within the first day or so after surgery. Steri-Strips affixing the suture should be left in place. The area should be kept clean and dry. Showering may begin the day after surgery. Tub bathing, saunas and other environments that place the incision in a moist or wet environment for any length of time should be avoided until the incision heals.

Patients may begin driving when the pain has decreased to a mild level and mobility of the neck has improved, which varies between patients. Patients need to be able to turn their neck and body enough to see right and left while driving. You may not drive or operate machinery while on narcotic pain medication. Patients may return to sedentary work duties as early as 3-6 weeks after surgery, depending on your surgeon’s recommendation.

Physical therapy is typically started 2 weeks after surgery. Restrictions are gradually lifted over the 3-6 months following surgery. Maximum medical improvement usually occurs 6-7 months after surgery, although you will usually need additional visits past that time frame to obtain Xrays to assess the implants and the fusion.

The results of anterior cervical corpectomy and fusion surgery in the treatment of symptomatic, progressive, cervical spinal stenosis and myelopathy are generally good. The surgery serves to improve pain and function and prevent further neurologic deterioration. The fusion rate is significantly improved with the use of a small titanium plate, and typically eliminates the need for a halo postoperatively. Most patients are noted to have gradual improvement of their pain and function following surgery.