Cervical corpectomy: report of 185 cases and review of the literature

Object. This study was conducted to determine the indications, safety, effi cacy, and complication rate associated with performing corpectomy to achiev e anterior decompression of neural elements or for removing anterior lesion s. Methods. Between 1987 and 1998, 185 patients underwent cervical corpectomy for the treatment of degenerative spondylitic disease (81 cases), ossificat ion of posterior longitudinal ligament (16 cases), correction of postoperat ive kyphosis (31 cases), trauma (39 cases), tumor (10 cases), and infection (eight cases). Ninety-nine patients presented with myelopathy, 48 with rad iculomyelopathy, 24 with radicular pain, and 14 with neck muscle pain. Eigh ty-seven patients underwent a one-level corpectomy; 45 of these patients un derwent a discectomy at a different level. Seventy patients underwent a two -level corpectomy; 27 of these patients underwent a discectomy at a differe nt level. Twenty-eight patients underwent a three-level corpectomy. Autogra ft (iliac crest) was used in 141 cases and allograft (fibula) in 44 cases. All but six patients underwent fixation with an anterior plate-screw system . There were no operative deaths. During the procedure the vertebral artery was injured in four patients and preserved in two of them. No neurological sequelae were encountered. Postoperative hoarseness, transient dysphagia, and pain at the graft site were transitory and successfully managed. The fu sion rate was 98.8%. Six patients experienced transient deterioration after surgery but they improved. No patient experienced permanent neurological d eterioration and 160 (86.5%) improved. Conclusions. Corpectomy has an important role in the management of various degenerative, traumatic, neoplastic, or infectious disorders of cervical sp ine. Following treatment in this series, radiculopathy always improved and myelopathy was reversed in most patients.