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Surgical approaches to L5 corpectomy: a systematic review
Daniel D'Aquino1, Ahmad M Tarawneh2, Aaron Hilis1
1Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Summary
Surgical approaches for L5 corpectomy show high fusion rates (94%) and low complications (11.7%). Posterior-only surgery may reduce blood loss and mortality compared to anterior approaches.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Neurosurgery
Background:
- Pathologies of the L5 vertebra present significant surgical challenges.
- L5 corpectomy and reconstruction require careful consideration of surgical approach efficacy and safety.
Purpose of the Study:
- To systematically review the efficacy and safety of surgical approaches for L5 corpectomy and reconstruction.
- To compare outcomes across different surgical strategies for L5 pathologies.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Database search from 1970 to January 2020 for L5 Corpectomy, Spondylectomy, or Vertebrectomy.
- Outcome measures included surgery length, blood loss, fusion rates, complications, and mortality.
Main Results:
- Six studies met inclusion criteria, analyzing various L5 corpectomy approaches.
- High fusion rates (94%) and low overall complication rates (11.7%) were observed across all methods.
- Posterior-anterior approaches reported higher blood loss (mean 3230 ml) and perioperative mortality (9%) compared to posterior-only approaches.
Conclusions:
- L5 corpectomy demonstrates high fusion rates and manageable complication rates.
- Posterior-only approaches may be associated with lower blood loss and mortality.
- Direct comparisons between surgical strategies are limited by small case series and varied pathologies.
