Partial corpectomy for cervical spondylosis

Abstract

Study design: A retrospective review was performed of a single surgeon's experience with partial corpectomy over a 9-year period. The measures evaluated included fusion rate, complications, and neurologic symptoms.

Objective: To demonstrate the safety and efficacy of partial corpectomy for multilevel cervical spondylosis.

Summary of background data: Strategies for the surgical management of cervical spondylosis have included laminectomy, multilevel corpectomy, and multilevel discectomy. All have significant disadvantages, including high nonunion rates and late deformity. A procedure incorporating multilevel discectomy, partial corpectomy, strut graft, and plating is described. By removal of the anterior two thirds of the intervening vertebral body, visualization of the interface between the dura and the disc or PLL is enhanced, and osteophytes can be easily removed. Fusion rates are improved.

Methods: All partial corpectomy cases with a 2-year follow-up evaluation managed by the senior author for multilevel cervical spondylosis from 1991 to June 1999 were reviewed for the number of levels decompressed, graft source, use of plating, fusion success, and neurologic status.

Results: Most of the patients (n = 97) were managed with two-level discectomies, with 42 requiring treatment of three levels and 5 requiring treatment of four or more levels. Allograft was used in 60%. The remainder received iliac crest bone graft. The majority (81%) were plated. Of the cases with 2-year follow-up evaluation, the fusion rate was 95.8%, independent of the number of levels fused. Among the 11% who had continued problems, most had improved. Nonunions were higher in smokers.

Conclusions: Partial corpectomy is an effective strategy for treating multilevel cervical disc disease. It is associated with a high fusion rate. In addition, partial corpectomy facilitates a complete decompression by providing excellent visualization of the dural interface.