A 38 year old female, presented with a one level disc herniation. Dr. Pashman treated her with an Anterior Cervical Discectomy and Fusion.
Case Review:
One Level ACDF for a C5/6 Disc Herniation
Patient History:
38 year old female
C4-5 Degeneration with mild stenosis, but no C5 complaints
C5-6 Degenerative Disc Disease
Severe degenerative joint disease, C5-6
Foraminal stenosis, C5-6
Kyphotic spine, C5-6
C6 radiculopathy, pain to the thumb and hands bilaterally
Severe neck pain
Failed conservative therapy
We discussed fusion both C5- 6 and C4-5, but it appears to me at this point that she would be much better served by having a single anterior cervical diskectomy and fusion at the C5-6. She has no C5 nerve root complaints. I also told her that the probability is that instead of having a two-level fusion, she might do well by having an artificial disk replacement at C4-5 if this should ever become a problem.
Pre-op Films:
The patient has a disc herniation at the C5/6 level as marked. There is a mild bulge at C4/5, but this is asymptomatic.
Indications for Surgery:
Cervical 6 radiculopathy.
Severe degenerative joint disease, C5-6.
Foraminal stenosis, C5-6.
Kyphotic spine, C5-6.
Anterior mass of posterior osteophyte, necessitating subtotal vertebrectomy.
Failed conservative therapy.
Surgical Strategy:
Radical diskectomy, C5-6.
Subtotal vertebrectomy, anterior osteophyte, undergoing total osteophyte removal constituting one-third of vertebrae, C5 and C6.
Anterior interbody fusion with a Cornerstone device with autogenous bone graft, measuring 7 mm, C5-6.
Anterior plate fixation using an four-hole plate atC5-6.
Intraoperative somatosensory evoked potentials.
Intraoperative fluoroscopy.
Post-Op Films:
The patient is status post anterior cervical discectomy and fusion and is doing quite well. She has minimal shoulder pain. Her symptoms are much improved over her preoperative status. Her x-rays look good. Incision is well-healed. She has no more numbness and tingling in the fingers or hand.