A 38 year old female, presented with a one level disc herniation. Dr. Pashman treated her with an Anterior Cervical Discectomy and Fusion.
One Level ACDF for a C5/6 Disc Herniation
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.
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.
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.
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.