Myeloradiculopathy, Stenosis, and spinal cord compression: Case 17

Case Review #7: 64 year old male with Cervical Myeloradiculopathy from Robert Pashman

A 64 year old male presented with myeloradiculopathy, stenosis, spinal cord compression, and numbness in his hands. Dr. Pashman treated the patient with an Anterior Cervical Discectomy and fusion at C6/7.

Case Review:

64 year old male, with severe myeloradiculopathy and stenosis.

Patient History:

64-year-old male
Severe myeloradiculopathy evidenced as upper motor neuron signs including hyperreflexia and numbness in the hands bilaterally, including the ulnar distribution.
This is referable to a critical spinal stenosis at C6-7 with cord compression circumferentially. The patient has degenerative disk disease and other problems cephalad to the critical stenosis, but this is the one that is causing a severe myeloradiculopathy.

Indications for Surgery:

1. Severe myeloradiculopathy with critical spinal stenosis, C6-7.
2. Hard and soft disk causing #1 diagnosis, C6-7.
3. Neural foraminal stenosis of C6-7, now with impending motor sensory deficit.
4. Severe degenerative disk disease, C6-7.

Surgical Strategy:

Radical diskectomy under the microscope for spinal cord decompression for myeloradiculopathy, C6-7.
Interbody fusion with PEEK device measuring 8- mm at C6-7.
Reversal cervical kyphosis with reconstruction, C6-7.
Anterior cervical plate fixation using 4-hole trestle plate, C6-8.
Intraoperative fluoro management.