Thoracic corpectomy and vertebral body reconstruction (TCVBR): a systematic review and meta-analysis.

Abstract

INTRODUCTION: Thoracic corpectomy (TCo) and vertebral body reconstruction (TCVBR = Thoracic corpectomy and vertebral body reconstruction) is a critical surgical procedure addressing severe thoracic spinal pathologies stemming from trauma, infection, tumor, or degenerative disease. Its primary goals are to restore spinal alignment, decompress neural elements, and ensure mechanical stability. This meta-analysis systematically evaluates the clinical presentation, etiologies, and outcomes of TCVBR. METHODS: A comprehensive literature search was conducted across PubMed, Google Scholar, Scopus, Web of Science, and Embase, encompassing publications from 1995 to March 2025. Studies including adult patients undergoing thoracic corpectomy with TCVBR were eligible if they reported outcomes such as kyphotic angle correction, neurological status, pain scores, or complication rates. Data from cohort studies were analyzed using random-effects models, while case reports/series were descriptively analyzed. RESULTS: This meta-analysis included 17 studies (1995–2023), comprising a pooled cohort of 649 patients (359 male, 289 female). The mean patient age was 54.97 years, with a mean follow-up of 19.88 months. Etiologies included malignancy (58%), infection (26%), trauma (11%), and spinal deformity (7%). Preoperatively, median VAS pain was 8, and the mean kyphotic angle was 27.6 degree. Postoperatively, median VAS improved to 2, and the mean kyphotic angle to 18.7 degree. Significant neurological improvement was observed in 49.2% of patients. Surgical approaches were predominantly posterior (77%), with over 90% of procedures being single-stage. The overall complication rate was 23%, with dural tears (8%), implant-related screw complications (7%), and surgical site infections (6%) being notable. The reoperation rate was 6%. CONCLUSION: TCVBR is a highly effective and transformative procedure, providing significant pain relief, substantial kyphotic deformity correction, and crucial neurological recovery for patients with severe thoracic spinal pathologies, primarily malignancy and infection. While associated with a notable complication rate, detailed insights into specific complications and reoperation rates are crucial for refining surgical strategies and optimizing patient outcomes in this complex yet vital intervention.