Spinal cord herniation following multilevel anterior cervical discectomy and fusion: A case report and literature review

Surgical Neurology International
Siddharth Sinha, K Joshi George

Abstract

Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal operations. Spinal cord herniation following these procedures is rare, more typically being described as occurring posteriorly rather than following anterior corpectomy and fusion (e.g., reported in four corpectomy cases). Here, we describe a case in which spinal cord herniation was attributed to a three-level ACDF. A 31-year-old male initially presented with a 1 year's duration of increasing myelopathy attributed to MR documented three-level disc disease (C4-C7). He successfully underwent a three-level ACDF without complications/durotomy. One year later, he again presented, with myelopathy (i.e., recurrent neck pain and stiffness) newly attributed to MR documented anterolateral C4-C5 cord herniation. As he declined further surgery, he was treated medically (e.g., utilizing analgesia and physiotherapy) and was no worse 6 months later. The occurrence of spinal cord herniation through a prior ACDF defect must be considered when patients present with recurrent myelopathy following previous ACDF surgery.

References

Oct 1, 1973·Journal of Neurosurgery·C Cobb, G Ehni
Nov 1, 1958·Journal of Neurosurgery·R B CLOWARD
May 3, 2008·The Journal of Bone and Joint Surgery. American Volume·David HannallahJames D Kang
Sep 19, 2019·Surgical Neurology International·Nancy E Epstein
Jan 10, 2020·World Neurosurgery·Megan M Finneran, Keith Schaible

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