Long-term results of 107 cases undergoing posterior approach for transpedicular corpectomy with instrumentation and circumferential arthrodesis from a single-center

Abstract

Abstract Study design: Retrospective cohort study. Objectives: We aimed to evaluate the less morbid and efficacy of posterior transpedicular corpectomy and circumferential instrumentation using a cage or bone graft for thoracolumbar corpectomy. Methods: This study was performed using the medical records of 107 consecutive patients treated surgically between June 1999 and July 2021. The patients suffering from spinal cord compression due to thoracolumbar vertebral pathologies as trauma, tumor, and osteomyelitis that involved T5 to L5 segments underwent posterolateral transpedicular corpectomy with or without sagittal balance reconstruction. Circumferential reconstruction was accomplished using either mesh cages or strut bone graft along with posterior instrumentation and fusion. The demographic data, clinical presentation, neuroradiological findings, surgical treatment methods, and therapeutic outcomes were analyzed. Results: The average age was 51.03 (range: 17 to 76) years. The pathological fractures were due to primary or metastatic bone tumors in 80 (74.77%) cases, granulomatous infections in 16 (14.95%) cases, and trauma in 11 (10.28%) patients. There were no perioperative mortalities and the mean follow-up period was 48 months (range: 14 to 166 months). Therapeutic outcomes revealed satisfactory clinical recovery in all patients. Conclusion: Transpedicular posterior corpectomy and circumferential construction is a proper, effective, and reliable surgical technique for a wide spectrum of thoracolumbar vertebral pathologies. Attributed to lower complication rates and shorter length of hospital stay compared to the anterior route, it must be considered in selected cases as an alternative to the difficult anterior approach.