A Multicenter Retrospective Study on Single-Level Thoracolumbar Corpectomy and Vertebral Body Replacement by Neurosurgeons

Background: Vertebral body replacement (VBR) with expandable cages after corpectomy is a critical procedure in spinal surgery, addressing conditions like fractures and tumors that compromise the anterior column of the spine. The eXtreme Lateral Interbody Fusion (XLIF) approach has revolutionized this technique by minimizing muscle dissection and reducing recovery times compared to traditional approaches. Methods: A retrospective clinical study was conducted on 23 consecutive patients who underwent single-level corpectomy and VBR between 2018 and 2023. Surgical outcomes were evaluated using visual analog scale (VAS) for pain and American Spinal Injury Association (ASIA) for neurological status. Radiological assessments included preoperative and postoperative CT scans to measure regional angulation and stability. Results: Postoperatively, patients showed significant pain reduction (median VAS score decreased from 8 to 2) and neurological improvement (82.6% ASIA E classification). Radiologically, there was a median kyphotic angle correction of 5° post-dorsal stabilization and 9° post-ventral stabilization. Complications included pleural injuries (8.7%) and hypoesthesia (8.7%), with higher incidence in thoracic VBR cases and patients with osteoporosis. Conclusion: VBR via XLIF is a promising technique for treating vertebral fractures and tumors, offering substantial pain relief, neurological recovery, and spinal stability. Despite some complications, the procedure demonstrates significant clinical and radiological benefits, underscoring its efficacy in complex spinal pathologies.