Case Review:Cervical Adjacent SegmentDegenerationRobert S Pashman, MDScoliosis and Spinal Deformity Surgerywww.eSpine.com
Patient History51 year old femaleStatus post fusion at C4-5, C5-6 and C6-7The patient has superadjacent degeneration at C3...
Pre-op X-rays
Indications for SurgeryStatus post anterior cervical discectomy and fusion,November 2004, at C4-C5, C5-C6, and C6-C7.Super...
Surgical StrategyRadical discectomy, C3-C4, with spinal corddecompression under the microscope.Anterior interbody fusion u...
Post-Op FilmsPrevious fusion
Pre-Op/Post-op Comparison                              Normal disc                            height has been             ...
Pre-Op/Post-op Comparison                        Pre-op                                  Post-opPatient is doing well. Inc...
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Case Review #4: 51 year old female with adjacent segment degeneration

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A 51 year old female, presented after a previous 3 level cervical spine fusion. The patient developed a cervical disc herniation adjacent to the previous fusion. Dr. Pashman treated her by extending her cervical fusion.

Published in: Health & Medicine
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Transcript of "Case Review #4: 51 year old female with adjacent segment degeneration"

  1. 1. Case Review:Cervical Adjacent SegmentDegenerationRobert S Pashman, MDScoliosis and Spinal Deformity Surgerywww.eSpine.com
  2. 2. Patient History51 year old femaleStatus post fusion at C4-5, C5-6 and C6-7The patient has superadjacent degeneration at C3-4above the previous fusion.The patients symptoms have gotten very bad. She hasright shoulder pain. There is no problem at C7-T1. Theeffacement of the spinal cord and fractional kyphosis isnoted.She has been treated conservatively with blocks andphysical therapy for a long time.
  3. 3. Pre-op X-rays
  4. 4. Indications for SurgeryStatus post anterior cervical discectomy and fusion,November 2004, at C4-C5, C5-C6, and C6-C7.Superjacent degeneration at C3-C4 with spinal cordcompression.Fractional kyphosis.Some motor/sensory deficit.Significant proximal pain radiating to the trap region intoher arms and intermittently into her back.Failed conservative therapy.
  5. 5. Surgical StrategyRadical discectomy, C3-C4, with spinal corddecompression under the microscope.Anterior interbody fusion using Cornerstone 7-mmdevice, C3-C4, with autogenous bone centrally.Anterior cervical plate fixation with four-hole AtlantisVision plate, C3-C4.Removal of retained instrumentation and exploration offusion mass, C4 to C7.Intraoperative somatosensory-evoked potentials.Intraoperative fluoroscopy.
  6. 6. Post-Op FilmsPrevious fusion
  7. 7. Pre-Op/Post-op Comparison Normal disc height has been restored Pre-op Post-op
  8. 8. Pre-Op/Post-op Comparison Pre-op Post-opPatient is doing well. Incision well-healed. X-rays look good. No evidenceof problems with the instrumentation. Sub adjacent spine is fused.

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