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Lumbar Vertebrectomy and Corpectomy

What does “Lumbar Vertebrectomy/Corpectomy” mean?

Here is the meaning of each word:

  1. Lumbar: the part of the spine located in the low-back
  2. Vertebrectomy: to remove most or the whole vertebra of the spine
  3. Corpectomy: to remove most of or the whole body of the vertebra

Altogether, “Lumbar Vertebrectomy” means removing most of or the whole vertebra of the low back.

What is the difference between the terms “Vertebrectomy” and “Corpectomy”?

The term Vertebrectomy and Corpectomy are very similar and are often used interchangeably when talking about this surgery. Both refer to removing a portion of the body of a Vertebra. “Corpectomy” specifically means removing a portion or the whole body of the Vertebra. “Vertebrectomy” means the removal of most of the vertebra, or the whole Vertebra.

What is a Lumbar Vertebrectomy/Corpectomy?

A Lumbar Vertebrectomy is a surgery done through the abdominal or flank (sides) area which removes a portion or all of the body of the vertebra and then puts bone and metal in its place for stability.

Why is a Lumbar Vertebrectomy/Corpectomy done?

A Lumbar Vertebrectomy is usually done for these reasons:

  1. Fracture of the Vertebra with complications
  2. Bone Cancer of the Vertebra
  3. Infection of the Vertebra

In both situations, the fear is that the vertebra could collapse since infection and cancer weaken the bone. By removing the weakened bone and replacing it with a metal cage and bone, the area is now strengthened.

How is a Lumbar Vertebrectomy/Corpectomy done?

Here are some of the steps of how this surgery is done:

  1. An intravenous catheter (IV) is placed and antibiotics are given.
  2. The patient is taken to the Operating Room and initially placed on the back (supine).
  3. A General Anesthetic is given.
  4.  The patient is carefully placed either on the side (lateral) or the back (supine).
  5. The abdominal area is cleaned with a sterile surgical solution. Plastic sheets (drapes) are placed around the surgical site.
  6. The surgeon makes a cut (incision) either on the abdomen or the flank (side of the abdomen).
  7. The muscles of the abdomen are opened and pushed aside.
  8. The peritoneum (sac which contains the organs of the abdomen) is pushed aside until the spine can be seen.
  9. An X-Ray machine is used to find the correct vertebra.
  10. Specialized instruments are used to remove part or all of the vertebra and adjacent discs.
  11. A metal cage is filled with bone or bone substitute and placed into the area where bone from the vertebra was removed. It is secured to the vertebrae above and below.
  12. The abdominal cavity, tissue and skin are closed.
  13. The patient is now carefully placed on the stomach.
  14. The skin in the low-back (lumba spine) is cleaned with a sterile surgical solution. Plastic sheets (drapes) are used to keep the surgical area sterile.
  15. A cut (incision) is made in the middle of the spine.
  16. The tissue and muscles are moved to the sides.
  17. The pedicles of the vertebra to be fused are found with an X-Ray machine.
  18. Small titanium screws are placed through the pedicle into each vertebral body. This is done on each side of the vertebra.
  19. Titanium rods are attached to the screws.
  20. Bone or bone-substitute material is place next to the screws and rods.
  21. The tissue and skin are closed.
  22. The patient is turned on the back (supine) and awoken from Anesthesia.
  23. The patient is then taken to the Recovery Area.

How long does it take to complete a Lumbar Vertebrectomy/Corepectomy?

A Lumbar Vertebrectomy can take 3-6 hours or more of surgery to complete.

What is the recovery like from a Lumbar Vertebrectomy/Corpectomy?

Here are some of the steps for the recovery from a Lumbar Vertebrectomy:

  1. The patient is admitted to the hospital often for 3-7 days.
  2. A number of X-Rays are taken during the hospital stay.
  3. Often physical therapy is used to help mobilize the patient.
  4. A firm brace is often used for weeks to months after surgery.
  5. The patient will have activity restrictions such as lifting, bending, etc. for weeks to months after surgery.
  6. The wound will take 4-6 weeks to heal.
  7. The surgeon will usually reevaluate the patient in the office within a week after discharge from the hospital.
  8. The bone fusion can take 6 months to 1 year or more to complete.

What kind of benefit can patients gain from a Lumbar Vertebrectomy?

This depends on the reason for the surgery.

  1. For infection, the benefit is that the surgery is part of the treatment of the infection. Also, the spine can now be stable without fear of collapse of the vertebra.
  2. For cancer, the benefit is that the spine is now stable, and cannot collapse in the segment where the surgery took place. Due to that, the patient can be more active once recovered from the surgery.