Who is a candidate?
Corpectomy is considered when spinal cord compression lies behind a vertebral body rather than at the disc spaces, most often from bone spurs, a calcified posterior longitudinal ligament, tumor, infection, or a burst fracture. It is a more extensive operation than ACDF and is chosen when a disc-level decompression would not reach the problem.
How the procedure works
The approach is from the front of the neck, as for ACDF. The discs above and below the affected vertebra are removed, then the central portion of the vertebral body itself, until the compression behind it is fully cleared. A structural implant or strut graft is placed to restore height and carry load, and a plate usually secures the construct while the bone fuses.
Recovery
Hospital stay is generally longer than after a single-level ACDF. Sore throat and swallowing difficulty are common early and settle over days to weeks, occasionally longer than after a simpler anterior operation. A collar is often used for a period. Myelopathic recovery (balance, hand function) is gradual and incomplete in some cases, particularly where compression was longstanding.
Benefits and alternatives
Corpectomy provides direct, complete access to compression that cannot be reached any other way from the front. Alternatives include multi-level ACDF where the compression is confined to the disc levels, posterior decompression with or without fusion, laminoplasty in suitable anatomy, and combined front-and-back approaches for the most complex cases.
Risks
Risks include infection, bleeding, hoarseness, swallowing difficulty which can be more pronounced than after ACDF, nerve or spinal cord injury, graft or implant displacement, and failure of the bone to fuse. Multi-level reconstructions carry higher rates of these complications, and Dr. Adapa reviews them specifically against your own imaging.