Morphometrical evaluation of decompression obtained through corpectomy. Heading towards to posterior approaches

Neurocirugia (Astur : Engl Ed). 2019 Mar-Apr;30(2):60-68. doi: 10.1016/j.neucir.2018.11.004. Epub 2018 Dec 20.
[Article in English, Spanish]

Abstract

Introduction: We analysed the decompression obtained by dorsal or dorsolumbar corpectomy measured by Cobb angle and the spinal area prior to and after surgery and compared the evolution of the technique over the last five years of the study.

Material and method: A retrospective review of patients operated between 2005 and 2015 through anterior or posterior approaches was performed.

Results: 24 patients were studied and a significant improvement was observed between the preoperative and postoperative morphometrical measurement (4.18° correction of the kyphosis and an increase of 130.8mm2 in the spinal canal, p<.001 in both cases) and in clinical parameters (45.8% of patients improved in ASIA, and Karnofsky showed 13 points of improvement, p<.001 in both cases). However, there was no correlation between clinical and morphological parameters. We also observed that in the last five years of the study posterior approaches were more frequently used with good results.

Conclusions: Dorsal corpectomy allows significant spinal decompression, with neurological improvement but this does not correlate with the measurement of decompression. Thanks to technical improvements, less invasive techniques (posterior approaches and MISS) allow good clinical results, which are similar to those obtained by anterior techniques.

Keywords: Abordajes posteriores; Canal medular; Cobb angle; Corpectomy; Corpectomía; Posterior approaches; Spinal canal; Ángulo de Cobb.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Laminectomy / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / surgery*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Time Factors
  • Treatment Outcome
  • Young Adult