Corpectomy

Corpectomy Risks - Neck Surgery Risks

Corpectomy is an extensive surgical procedure, with all of the associated risks. The longer surgical time means that more blood is likely to be lost, and there is a statistically larger risk of infection. The risks are still very low in relation to the chances of achieving significant pain relief. Patients are encouraged to be mindful of the risk of infection, with any redness, fluid leakage, pain, and tenderness of the area reported to physicians. If fever occurs, or a persistent headache then they should seek help immediately as this may indicate a tear in the dura which can lead to infected meninges (spinal meningitis). There is a risk of damage to the vertebral artery when excising the vertebral body. This can lead to life-threatening blood loss, or a cerebrovascular accident (stroke), particularly in cases where the surgeon is removing a tumor or there is vertebral infection present.

Risks of Straining the Neck

Patients should continue to wear the hard cervical collar until cleared by their doctor. This minimizes the risk of acute strain on the neck and displacement of the graft occurring. As with any fusion, there is a chance that extra pressure may be placed on the adjacent segments in the cervical spine with ramifications for further degeneration and necessity of other surgeries. Following the rehabilitation guidelines will reduce this risk. There is also a chance that the graft will not take, although this is less likely in the anterior cervical spine than in the posterior cervical spine. Refraining from smoking will help improve chances of fusion happening.

Risk of Nerve Damage

It is possible that damage can occur to the nerves in the cervical spine, the trachea, the thoracic duct, and the oesophagus. Depending on the approach taken, transverse or oblique, the risks of these vary as does the risk of damage to the laryngeal nerve. This nerve is involved with speech and if knocked or damaged during surgery may result in a hoarseness of the throat or speech problems post-surgery. Mayr (2002) observed a 14.1% incidence of hoarseness following surgery, which was transient in all but two patients (0.8%). The spinal cord can also be injured during this surgery, with a risk of complete or partial quadriplegia present, but very low. Some surgeons opt to use somatosensory evoked potentials (SSEPs) to monitor spinal cord function during the operation. However, there is debate over the use of this technique as it does not affect the quality of the surgery and may unnecessarily extend the operating time.

Why a Corpectomy is Riskier than other Procedures

The risks associated with corpectomy may be slightly higher than with other spinal surgeries for a number of reasons. Firstly, the surgery itself is more complicated, making it longer than other operations. Secondly, there is a longer recovery period, with more of an opportunity for things to interfere with proper rehabilitation and recovery. Lastly, the patients who undergo this procedure generally already have extensive spinal stenosis and spinal cord issues, making them statistically more likely to have complications regardless of the skill of the surgical team. Improvements in technique and the hardware used during, and after, the operation have significantly reduced the incidence of complication with this procedure.

Next read about: Benefits of a Corpectomy





Last Updated: 11/11/2010