From less to maximally invasiveness in cervical spine surgery: A "nightmare" case who deserve consideration

International Journal of Surgery Case Reports
M VisocchiA Spallone

Abstract

Multilevel cervical myelopathy without surgical treatment is generally poor in the neurological deficit without surgical decompression. The two main surgical strategies used for the treatment of multilevel cervical myelopathy are anterior decompression via anterior corpectomy or posterior decompression via laminctomy/laminoplasty. We present the case of a 62 year-old lady, harboring rheumatoid artritis (RA) with gait disturbances, pain, and weakness in both arms. A C5 and C6 somatectomy, C4-C7 discectomy and, instrumentation and fusion with telescopic distractor "piston like", anterior plate and expandable screws were performed. Two days later the patient complained dysfagia, and a cervical X-ray showed hardware dislocation. So a C4 somatectomy, telescopic extension of the construct up to C3 with expandible screws was performed. After one week the patient complained again soft dysfagia. New cervical X-ray showed the pull out of the cranial screws (C3). So the third surgery "one stage combined" an anterior decompression with fusion along with posterior instrumentation, and fusion was performed. There is a considerable controversy over which surgical approach will receive the best clinical outcome for the minimum cost in the comp...Continue Reading

References

Nov 12, 1998·Journal of Spinal Disorders·A R VaccaroS R Garfin
Aug 17, 2002·Neurosurgery·Jean-Valéry C E CoumansFraser C Henderson

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Citations

May 1, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Wenqi LuoJianhui Zhao
Aug 10, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yachao ZhaoWenyuan Ding

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Methods Mentioned

BETA
X-ray

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