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Oblique corpectomy in the cervical spine
Tomasz Tykocki1, Łukasz A Poniatowski2,3, Marcin Czyz4
1Spinal Unit, Royal Victoria Infirmary, Newcastle, UK. ttykocki@gmail.com.
Study Design:
A narrative review.
Objectives:
A literature review of studies reporting on the application of oblique corpectomy (OC) in various pathologies of the cervical spine.
Setting:
UK.
Methods:
A search was carried out using the PubMed and Google Scholar up to 18 March 2017. Finally, 26 studies met the inclusion criteria.
Results:
A multilevel OC shows good clinical outcomes in various pathologies in the cervical spine. The clinical improvement in cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament was found to be over 70%. OC allows wide anterior decompression of the spinal cord and complete unilateral nerve root decompression. The approach carries a risk of Horner's syndrome, vertebral artery and accessory nerve injury. OC does not compromise spine stability and osteoarthrodesis with bone grafting is not necessary. Spinal motions are preserved and appear close to normal. OC can be applied in patients with a low fusion rate such as the elderly, diabetics, and heavy smokers. Furthermore, OC was found to be an optimal approach for exta-intradural tumors of the cervical spine.
Conclusions:
OC seems to be a valid alternative for the management of multisegmental CSM in selected cases. It should not be considered a first-line treatment strategy due to the relatively high morbidity. There are no studies comparing OC without fusion to other treatment options in CSM. Therefore, rigorous prospective studies using validated outcome measures with long-term follow-up are required.
