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Hemicorporectomy

T C Stelly1, J W McNeil, S R Snypes

  • 1Department of Surgery, College of Medicine, University of South Alabama, Mobile.

Clinical Anatomy (New York, N.Y.)
|January 1, 1995
PubMed
Summary
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Hemicorporectomy is a life-saving surgical option for severe paraplegia complications like decubitus ulcers and osteomyelitis when other treatments fail. This radical procedure involves translumbar amputation and requires extensive post-operative rehabilitation.

Area of Science:

  • Surgical Oncology
  • Reconstructive Surgery
  • Trauma Surgery

Background:

  • Paraplegia can lead to severe complications such as intractable decubitus ulcers and femoropelvic osteomyelitis.
  • Standard therapies include wound care, diversion procedures, and reconstructive flaps, but may fail in severe cases.

Observation:

  • A 28-year-old paraplegic patient presented with sepsis, malnutrition, contractures, severe infected ulcers with exposed bone, and incontinence.
  • The patient's condition was recalcitrant to conservative management, necessitating a more aggressive approach.

Findings:

  • Hemicorporectomy, a translumbar amputation, was successfully performed, along with colostomy, ureteroileal conduit, gastrostomy, and other reconstructive measures.
  • Key surgical considerations included a potential two-stage approach, preservation of abdominal musculature, careful vessel ligation, and specific vertebral and dural management.

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Implications:

  • Hemicorporectomy offers a curative option for otherwise untreatable, life-threatening complications of paraplegia.
  • Successful outcomes depend on meticulous surgical technique, pre-operative optimization, and comprehensive post-operative rehabilitation, including prosthetic adaptation.