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Looking Up and Down the Spinal Column after Cervical Corpectomy
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Posted on: 03/15/2004
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Sometimes neck pain and pressure on the spinal cord require surgery to remove bones in the cervical spine. One such operation is called a corpectomy. The front part of a section of the spinal column is removed. Bone is grafted to hold the spine in place. A metal plate may be used to support the column until the fusion takes hold.
Some studies show an increase of degenerative arthritis in the spine just above or below the corpectomy. Other studies don't agree with this finding. There is some thought that increased internal stress occurs at the adjacent segments. This occurs as a result of a change in the load after corpectomy.
In this study, 44 patients had one- or two-level corpectomies. Doctors used MRI and X-rays to look at what happened at the next (adjacent) level. They compared the results with changes in a segment farther away (the control level). They called the control level the remote segment.
Symptoms improved in 43 of the 44 patients after the operation. There were no major changes in the discs for either the adjacent or remote segments. There was a decrease in the size of the spinal canal around the spinal cord at the adjacent level.
The authors report that degenerative changes occurred at adjacent levels in 75 percent of the patients after central corpectomy. They think changes in the spinal ligaments are more to blame for the decreased canal size. It's likely that an increased load occurs from this factor rather than strain from lack of motion at the fused site. The authors base this theory on the fact that there was no major change in the disc height, which would be expected with increased loading.
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References:
Vaijayantee Kulkarni, MCh (Neuro), et al. Accelerated Spondylotic Changes Adjacent to the Fused Segment Following Central Cervical Corpectomy: Magnetic Resonance Imaging Study Evidence. In Journal of Neurosurgery: Spine. January 2004. Vol. 100. No. 1. Pp. 2-6.
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