The lamina is the back part of the vertebra that covers the spine, and bony overgrowths sometimes called bone spurs that develop here can cause compression and narrowing. The multilevel oblique corpectomy moc allows widening of the spinal canal and foramen trough via an anterolateral access to the cervical spine with control of. Multilevel oblique corpectomy for cervical spondylotic. An anterior cervical corpectomy and fusion is typically recommended only after conservative treatment methods fail. Recent reports suggest that there are several nontraditional management strategies that merit attention. Anterior cervical corpectomy wascher cervical spine institute. So an anterior cervical corpectomy is a procedure that removes damaged vertebrae and intervertebral discs from the spine in the neck, using a surgical approach through the front of the neck. Surgery involved anterior cervical exposure and partial oblique corpectomy, which was essentially an extended midline and lateral undercutting of the body. Jan 11, 2012 to document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy occ for cervical compressive myelopathy. Pdf multilevel oblique corpectomy for cervical spondylotic. The authors describe the use of anterolateral partial oblique corpectomy in 40 patients with cervical myelopathy. Guidelines are intended as educational tools for a multidisciplinary audience to improve patient care by outlining reasonable informationgathering and decisionmaking processes used in the management of back pain in adults. Multilevel oblique corpectomy without fusion in managing cervical. Cervical corpectomy is a surgical procedure performed to decompress the nerve roots andor spinal cord by removing vertebrae in the cervical spine neck.
Cervical laminectomy mischer neurosciences spine and back. To document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy occ for cervical compressive myelopathy. Simply oblique corpectomy oc or more precisely anterolateral cervical oblique transcorporeal approach with oblique partial corpectomy is an alternative to anterior median or central corpectomy for decompression of the spinal cord, which is mainly performed for the treatment of spondylotic myeloradiculopathy and tumor removal. Pdf to document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy occ for cervical. More recently, techniques using lateral multiple oblique corpectomy moc andor foraminotomy 1928 have been used with. Multilevel oblique corpectomy for cervical spondylotic myelopathy. Oblique corpectomy in the cervical spine spinal cord nature. Oblique corpectomy in the cervical spine request pdf. This retrospective study included 109 patients93 with cervical spondylotic myelopathy and 16 with ossified posterior longitudinal ligament in whom spinal curvature and range of segmental movements were.
Reimbursement questions nuvasive reimbursement guide the nuvasive reimbursement guide contains current spine arthrodesis procedure codes and descriptions, medicare drg and apc payment values, relevant. Oblique corpectomy to manage cervical myeloradiculopathy ncbi. A strut graft is a piece of bone 12 inches that is inserted into the trough created by the corpectomy ies and that supports the anterior vertebral column. He told me we had missed out on a lot of reimbursement because i was only coding these as a traditional acdf. May 26, 2016 to assess the longterm clinical and radiographic outcomes of anterior cervical corpectomy and fusion accf with a neotype nanohydroxyapatitepolyamide 66 nhapa66 strut in the treatment of.
When the cervical disorder is serious and is caused by more than a simple disc space problem, then doctor can recommend surgery where he will remove not just vertebral body but also the disc spaces at either end so that the cervical canal can be decompressed completely. Limited oblique corpectomy for treatment of ossified posterior. After a corpectomy has been performed, the surgeon needs to mechanically reconstruct the defect created and to provide the longterm stability of the spine with a spine fusion. The cervical oblique corpectomy oc approach has the advantages of no grafting or instrumentation necessities and theoretically maintains natural neck motions. Multilevel cervical oblique corpectomy andor lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal. The t2 stratosphere expandable corpectomy system is used in skeletally mature patients to replace a collapsed, damaged, or unstable vertebral body caused by tumor, trauma i. Caring for myself after anterior cervical corpectomy fusion. Your surgeon will take a number of factors into consideration before making this recommendation, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. Jul 01, 2012 multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion chacko, ari. Their data suggest that sagittal alignment can be maintained and the neurological deficits can be appropriately addressed with this approach. The authors describe a lateral approach to the cervical spine for the management of spondylotic myeloradiculopathy.
The multilevel oblique corpectomy moc allows widening of the spinal canal and foramen trough via an anterolateral access to the cervical spine with control of the vertebral artery and does not. When a corpectomy is done, the surgeon removes the vertebral body, as well as the disk above and below the vertebral body. The anterior corpectomy with strut grafting will be further studied in this article. May 12, 2015 cervical disc arthroplasty, artificial cervical disc replacement prestige disc duration. The oblique cervical corpectomy occ has slowly emerged as an established method of decompressing the spine in patients with cervical spondylotic myelopathy csm 410. Caring for myself after anterior cervical corpectomy and fusion 5 do not be afraid of hurting the wound because of the soap and water. Over last few years various clinical series 3439 about oblique corpectomy as well as experimental studies 40, 41 have been published. The theoretical advantages of this technique include motion preservation and avoidance of the possible problems associated with fusion and instrumentation of the cervical spine. This procedure is known as the cervical corpectomy operation. Anterior cervical corpectomy anterior in the human anatomy, referring to the front surface of the body or position of one structure relative to another cervical relating to the neck, in the spine relating to the. Surgical technique for the protection of the cervical. Oblique cervical corpectomy involves direct decompression of the spinal cord as well as the ipsilateral. Do not go in bath tubs, lakes, pools, or hot tubs until wound is completely healed. In between each of the 7 vertebrae of the cervical spine are soft pads or discs which act as shockabsorbers and allow for bending and movement of the head.
The rationale for this approach and surgical technique are discussed. Pdf oblique corpectomy to manage cervical myeloradiculopathy. While the portion of the bone that immediately surrounds the spinal cord remains, the entire vertebral body and the surrounding disk spaces are removed. Usually cervical corpectomy is performed to treat traumainduced cervical cord compression. Acdf with corpectomy orthopedic coding ask an expert. The technique of oblique corpectomy has been reported for the first time in 1993 to access lesions developed in the anterior part of the spinal canal 1. The anterior procedures include decompression and anterior reconstruction with an artificial disc and oblique corpectomy without.
Reimbursement nuvasive is dedicated to offering resources for healthcare professionals seeking a better understanding of coding, coverage, and payment related to our technologies and therapies. Cervical corpectomy nerve decompression spine back pain. George, an alternative method for anterior cervical corpectomy, is described. The reason it is attractive that it allows for a long segment of decompression up to five levels without the need for a bone graft or instrumentation as its proponents. Mar 24, 2017 anterior cervical fusion is a widely accepted treatment for cervical degenerative diseases, including spondylotic myelopathy and ossification of the posterior longitudinal ligament opll. The surgeon has to deal with gap left after corpectomy. The biomechanical effects of a twolevel oblique corpectomy. Anterior cervical corpectomy surgery spine institute of san. The lateral aspect of the cervical spine is reached and the vertebral artery is. It involves the removal of the vertebral body as well as the disc spaces at either end, to completely decompress the cervical canal. Request pdf oblique corpectomy in the cervical spine study design.
Anterior cervical corpectomy procedure an anterior cervical corpectomy surgical procedure is usually performed for spinal cord compression, caused by cervical arthritis, a bulging disc, or a thickened ligament. The evidence of failure of long constructs has been investigated in biomechanical studies. Sep 01, 2007 acervical corpectomy is indicated when the compression of the cervical spine is not only opposite the interspace, but also opposite the body. We are dedicated to providing a revolutionary approach to complete spine care that is unsurpassed. Is also performed on patients with symptomatic, progressive cervical spinal stenosis and myelopathy possible postop findings most patients are able to go home 45 days after surgery. Managing spondylotic cervical myeloradiculopathy using oblique. Nerves experiencing compression often due to bone spurs on the vertebrae causing the spinal column to narrow can result in neck pain, arm numbness, weakness, or other related symptoms. Functional outcome of corpectomy in cervical spondylotic. That oblique corpectomy didnt disturb the stability of the cervical spine and needs no stabilization. This procedure, a cervical corpectomy, is often done for multilevel cervical stenosis with spinal cord compression caused by bone spur osteophytes growth. An anterior cervical corpectomy is a procedure performed when cervical disease encompasses more than just the disc space, such as multilevel cervical stenosis or spinal cord compression caused by bone spur growth. T2 stratosphere expandable corpectomy system medtronic.
Do not keep the wound covered unless you have some drainage, and we instructed to do so. Oblique cervical corpectomy occ is a lateral cervical approach used as an alternative to a central corpectomy, with the advantage of preserving motion since no fusion is performed. Anterior cervical corpectomy, with or without plating, has been reported to achieve high fusion rates, improvement in myelopathy, and good to excellent outcomes. Cervical laminectomy is a decompression surgery of the cervical neck spine that is performed to create space in the spinal canal by removing bone called the lamina, as well as any enlarged ligaments causing pressure. The cervical spine can be reconstructed using autograft, allograft or bone cement6.
Since 1992, the technique of multilevel oblique corpectomy moc has been applied at lariboisiere hospital for the surgical treatment of spondylotic myeloradiculopathy and a first series has. Request pdf oblique corpectomy a modification of the oblique corpectomy first described by b. Anterior cervical corpectomy and fusion using a synthetic. The rate of neurological improvement for patients with csm undergoing corpectomy has been reported to be 3983%. Subaxial cervical spine injury classification slic injury morphology points compression burst 1 1 distraction 3 translation rotation 4 total max 4 dlc status points intact 0 intermediate 1 disrupted 2 total max 2 neuro status points intact 0 nerve root deficit 1 complete cord injury 2 incomplete cord injury 3 addon. Anterior cervical corpectomy is a surgery performed to take pressure off the nerves both within in the spinal cord and exiting the spinal column. Multilevel cervical oblique corpectomy andor lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal stability and physiological motion of the cervical spine. By avoiding the use of implants and fusion in oblique corpectomy, the procedure is cost effect with. Anterior cervical corpectomy the spine hospital at the. Longterm results of anterior cervical corpectomy and fusion. The surgeon returned to the office and was told that he could bill a corpectomy code in the anterior spine if he documented, scraping or smoothing of vertebral endplates.
Cervical spondylotic myelopathy csm and cervical spondylotic radiculopathy csr are classically approached by anterior single or multiple disc space decompression 1, 2, multilevel corpectomy, laminectomy 410, or laminoplasty 1118. A corpectomy is similar to a related procedure called a discectomy, and the two surgeries may be used to treat similar conditions. Pdf original article limited oblique corpectomy for treatment of. The oblique corpectomy, forgotten but an effective procedure. The cervical spine runs from the brain down through the cervical spine, controlling the bodys organs and limbs. Nass develops clinical practice guidelines regarding the diagnosis and treatment of spinal disorders. Its popularity may, however, increase with time and after publications such as this. Mar 03, 2016 our orthopaedic spine surgeon recently attended a presentation sponsored by a vendor other than your firm.
Alternative procedures for the treatment of cervical spondyl. Aug 19, 2011 anterior multiple cervical corpectomy and fusion in revision surgery duration. When is it appropriate to report anterior cervical corpectomy separately in addition to anterior cervical fusion. This retrospective study included 109 patients93 with cervical spondylotic myelopathy and 16 with ossified posterior longitudinal ligament in whom spinal curvature and range of segmental movements were assessed on neutral and. Anterior cervical corpectomy is often perfomed for multilevel cervical stenosis. To document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy occ for. Oblique cervical corpectomy in the management of unilateral.466 151 300 291 1388 203 558 15 521 603 71 190 849 198 1376 495 248 1355 870 1422 1469 232 362 1361 933 1169 1078 749 715 263 459 1337 405 882 744 1315 295 7 969 558 36 1239 79 1070