Female with a massive C5/6 disc herniation after a surfing accident

Patient A:  36 year old female with a massive C5/6 disc herniation after a surfing accident.  Emergent surgery with a Prestige Artificial Disc – and the patient was back to work and surfing within months.

Patient History:

36 year old female
Patient presented with neck pain radiating to the bilateral trapezial region,numbness and weakness in the hands, for approximately 3 weeks.

She has had PT, yoga and chiropractic, but no nerve blocks or medicines.

She went to see physiatry who ultimately referred her over to a spine surgeon who discussed alternatives of various surgeries, but then discharged her without medicine or protection.  She sought another surgical opinion, but the physician had not performed Total Disc Replacement surgery on a patient before.

The patient had a consult with Dr.  Pashman on same day.     She presented with complaints of trapezial pain, numbness and weakness in the hands.   The patient stated that she had clumsiness in her hands and weakness. The patient had difficulty with forced abduction of her arms over her head at this point.

On MRI the patient has a massive extruded disk herniation at C5-6 causing myeloradiculopathy with impending severe neurologic deficit including numbness and tingling in the hands, weakness, trapezial upper extremity with hyperreflexia in the upper and lower extremities and upper motor neuronsigns.

Indications for Surgery:

1. Massive extruded disk herniation, C5-6, with myeloradiculopathy.
2. Spinal cord compression with evolving upper motor neuron signs, weakness in the upper and lower extremities, evidence of severe nerve compression.
3. Degenerative disk disease, C5-6.
4. Failed conservative therapy.
5. Evidence of normal disks proximal and distal to extruded disk herniation, C5-6.

Surgical Strategy:

Radical diskectomy, spinal cord decompression under themicroscope, C5-6.
Placement of Prestige Artificial Disc replacement measuring 6×16, at C5-6.
Intraoperative somatosensory evoked potentials.
Intraoperative fluoroscopic control.

Post-operative Films:

The disc is perfectly aligned in the spine.