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Case Review #3: 44 year old male with a subadjacent disc herniation
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Case Review #3: 44 year old male with a subadjacent disc herniation

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A 44 year old male presented after a C5/6 fusion. On MRI he was found to have a subadjacent disc herniation. Dr. Pashman treated the patient with a Prestige Artificial Disc.

A 44 year old male presented after a C5/6 fusion. On MRI he was found to have a subadjacent disc herniation. Dr. Pashman treated the patient with a Prestige Artificial Disc.

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    Case Review #3: 44 year old male with a subadjacent disc herniation Case Review #3: 44 year old male with a subadjacent disc herniation Presentation Transcript

    • Case Review:Prestige Artificial Disc forsubadjacent degenerationat C6/7Robert S Pashman, MDScoliosis and Spinal Deformity Surgerywww.eSpine.com
    • Patient History44 year old malePrevious fusion C5-6, three years prior with physician inhis area.Increasing neck and shoulder pain.MRI shows a severe subjacent degeneration diskherniation at C6-7 with bilateral neural foraminalextension. The patient also has significant cordeffacement at C6-7.
    • Pre-op X-rays
    • Flexion and Extension X-rays
    • Indications for SurgeryStatus post anterior cervical diskectomy and fusion atC5-6.Now with subadjacent C6-7 disk herniation and spinalcord compression.Degenerative disk disease, C6-7.Bilateral myeloradiculopathy, C6-7.Failed conservative therapy.
    • Surgical StrategyRadical diskectomy with spinal cord decompression atC6-7, under the microscope, from a left-handedapproach.Bilateral neural foraminotomy at C6-7.Bilateral subtotal vertebrectomy at C6, with removal ofmass of uncal vertebral osteophyte inferiorly, superiorly,and anteriorly, constituting one-third of vertebra.Removal of retained hardware at C5-6.Placement of Prestige Disc at C6-7 measuring 7x18 mm,with four screw fixation.Intraoperative fluoroscopy.Intraoperative somatosensory evoked potentials.
    • Post-Op Films The patient is doing very well. No significant neck or arm pain following surgery.
    • Pre-Op/Post-Op Film ComparisonPrevious Previous fusion fusion Prestige Disc Degenerated Disc