Spinal Injuries, Tumors and Infections of the Cervical Spine

Surgical Excision and Reconstruction for Cervical Spine Conditions

Spinal injuries, tumors, and infections of the neck (cervical spine) can be life-threatening. Collaboration with an oncologist (for tumours) or an infectious disease physician (for infections) is an important component of care. Surgical excision of the damaged spine is often required to relieve pressure on the spinal cord and nerves, as well as reduce the overall disease burden. At the same time, reconstruction of the spine using titanium screws and rods helps stabilise the affected segment.

The surgery can be performed from the back (posterior), front (anterior), or a combination of both approaches. When both approaches are required, the procedures may be performed on the same day or staged approximately 5 to 7 days apart.

Anterior Cervical Corpectomy

In certain cases, an anterior surgical approach may be required to adequately decompress the spinal cord.

Cervical corpectomy (Figure 1) is a surgical procedure to remove a portion of the vertebra and adjacent intervertebral discs to decompress the cervical spinal cord and spinal nerves. In some patients, the spinal canal may be narrowed by conditions arising from the back of the vertebral body or the ligament behind the vertebral bodies. In such situations, it may be necessary to remove one or more vertebral bodies along with the discs above and below to achieve adequate decompression of the spinal cord and/or nerve roots.

A bone graft with a metal plate and screws is used to reconstruct the spine and provide stability. In some cases, the anterior procedure is combined with a posterior approach (Figure 2).

When to Consider Surgery

Surgery may be required when there is spinal instability, tumour growth, infection, or spinal cord compression affecting neurological function, and evaluation by a spine surgeon can help determine the most appropriate treatment approach.

Sporting activities can sometimes result in spinal injuries. On the Frontline programme, Dr Hee discusses on the risks of spinal injuries.