The technique of oblique corpectomy has been reported for the first time in 1993 to access lesions developed in the anterior part of the spinal canal 1).
Since 1992, the technique of multilevel oblique corpectomy (MOC) has been applied at Lariboisière Hospital for the surgical treatment of spondylotic myeloradiculopathy and a first series has been published in 1999 2).
From this time, several teams have confirmed favorable outcome 3) 4) 5) 6) , through retrospective but also prospective works 7) , and indications have been enlarged to ossification of the posterior longitudinal ligament 8) 9).
Multilevel cervical oblique corpectomy and/or lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal stability and physiological motion of the cervical spine 10).
The lateral foraminotomy and the oblique corpectomy technique, by preserving over 50% of the vertebral body and preserving two of the three columns, do not compromise spinal stability so that bone grafts or instrumental arthrodesis are not necessary 11).
Techniques using lateral multiple oblique corpectomy (MOC) and/or foraminotomy 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) have been used with increasing frequency. In general, when three or more levels are affected, the preferred techniques remain either an anterior multilevel corpectomy or a posterior route such as laminectomy, open door laminoplasty, and posterior foraminotomy. However, the best management of such pathology (especially if 3 or more levels are involved) remains controversial.
This study included two women and two men (aged 44-90) that received operations for removing ventral cervical SEAs. All patients presented with progressively increasing myelopathy, and 3 had severe comorbid conditions. In all cases, a multilevel OC without fusion was performed. The amount of bone resection was tailored to fit the needs of granulation removal, with an effort to retain as much of the vertebral bodies as possible. Then, pus was evacuated and debridement of granulation was performed, followed by rinsing and drainage.
The neurological status of 3 patients improved significantly after surgery. At the last follow-up examination, one showed full recovery, and in two a minor residual deficit persisted. During mean follow-up of 5.5 years, no internal stabilization was necessary. The oldest patient was tetraplegic, and had several concomitant diseases. That patient died from sudden cardiac arrest on the third postoperative day. Oblique corpectomy did not affect the anterior or posterior column. Additionally, it provided a broad view of the ventral aspect of the spinal canal.
Oblique corpectomy allows appropriate spinal cord decompression and granulation removal in the case of cervical spine epidural abscess, without sacrificing spinal stability 22).