A 53-year-old male presented with severe cervical kyphosis centered at C4-5, C5-6, and C6-7, causing spinal cord compression and myeloradiculopathy. Pre-op x-rays showed 78 degrees of kyphosis. The surgical strategy involved segmental spinal instrumentation from C4 to C7, radical diskectomies and deformity correction through osteotomies and vertebrectomies at C4-5, C5-6, and C6-7. Post-op x-rays showed successful reconstruction of natural cervical alignment and removal of 78 degrees of kyphosis.

1. Case Review:
Complex Cervical
Reconstruction
78°
Robert S Pashman, MD
Scoliosis and Spinal Deformity Surgery
www.eSpine.com

2. Patient History
53-year-old male
Severe spinal cord compression
Myeloradiculopathy
Increasing weakness in the upper
extremities.
Hypesthetic and hyperreflexic
The patient has severe cervical kyphosis
centered at C4-5, C5-6 and C6-7 with
posterior uncovertebral osteophyte and
soft disk ridging against the spinal cord.
There is a gliosis in the cord. The
patient requires multiple-level osteotomy
and vertebrectomies for correction of the
cervical kyphosis and reconstruction.

3. Pre-op X-rays
78°

4. Indications for surgery
1. Severe myeloradiculopathy due to spinal cord
compression at C4-5, C5-6 and C6-7.
2. Degenerative disk disease, C4-5, C5-6, C6-7.
3. Severe cervical kyphosis and deformity, C4-5, C5-6
and C6-7.
4. Failed conservative therapy.

5. Surgical Strategy
1. Segmental spinal instrumentation C4 to C7 using an
eight-hole Atlantis Vision cervical plate.
2. Radical diskectomies with cervical deformity correction,
C4-5, C5-6 and C6-7 using microscope spinal canal
decompression for myeloradiculopathy.
3. Osteotomy, subtotal vertebrectomy, C4-5, C5-6 and C6-
7 for removal of severe uncovertebral osteophytes,
lateral annular ossified ridges for correction of cervical
kyphosis.
4. Anterior interbody fusion with cervical allograft devices
measuring 6, 6, and 6 mm, C4-5, C5-6 and C6-7, with
autogenous bone centrally.

6. Post-op x-rays

7. Post-op Comparison x-rays
It is important to notice
that the natural cervical
alignment was
reconstructed with
surgery. This removed
the pressure from the
spinal cord and discs,
alleviating pain.

8. Post-op Comparison X-rays
78°