53 year old male presented with arm weakness, severe spinal cord compression, and degenerative disc disease. Dr. Robert Pashman treated the patient with an anterior cervical disectomy and fusion.
Case Review:
Complex Cervical Reconstruction
Patient History:
53-year-old male
Severe spinal cord compression
Myeloradiculopathy
Increasing weakness in the upper extremities.
Hypesthetic and hyperreflexic
The patient has severe cervical kyphosis centered at C4-5, C5-6 and C6-7 with posterior uncovertebral osteophyte and soft disk ridging against the spinal cord. There is a gliosis in the cord. The patient requires multiple-level osteotomy and vertebrectomies for correction of the cervical kyphosis and reconstruction.
Pre-op X-rays were taken
Indications for surgery:
1. Severe myeloradiculopathy due to spinal cord compression at C4-5, C5-6 and C6-7.
2. Degenerative disk disease, C4-5, C5-6, C6-7.
3. Severe cervical kyphosis and deformity, C4-5, C5-6 and C6-7.
4. Failed conservative therapy.
Surgical Strategy:
1. Segmental spinal instrumentation C4 to C7 using an eight-hole Atlantis Vision cervical plate.
2. Radical diskectomies with cervical deformity correction, C4-5, C5-6 and C6-7 using microscope spinal canal decompression for myeloradiculopathy.
3. Osteotomy, subtotal vertebrectomy, C4-5, C5-6 and C6- 7 for removal of severe uncovertebral osteophytes, lateral annular ossified ridges for correction of cervical kyphosis.
4. Anterior interbody fusion with cervical allograft devices measuring 6, 6, and 6 mm, C4-5, C5-6 and C6-7, with autogenous bone centrally.
Post-op Comparison x-rays:
It is important to notice that the natural cervical alignment was reconstructed with surgery. This removed the pressure from the spinal cord and discs, alleviating pain.