J Minim Invasive Spine Surg Tech.  2018 Jun;3(1):34-38. 10.21182/jmisst.2017.00269.

Treatment of Two Level Artificial Disc Replacement for Cervical Spondylotic Myelopathy

• Kang MS
• Kim KJ
• Bae JS
• Jang IT

• KMID: 2562034
• DOI: http://doi.org/10.21182/jmisst.2017.00269

Abstract

Cervical spondylotic myelopathy (CSM) is a common spinal disorder caused by compression of the spinal cord, due to degeneration of the cervical spine. We investigated post-operative results and suggest artificial disc replacement (ADR) as an effective surgical method for treating CSM. We present the case of a 36-year-old man, with nuchal pain; severe paresthesia of both upper and lower extremities; and pain, motor weakness, and difficulty in fine motor control of both hands. A cervical X-ray showed spondylotic changes at the C5-6, C6-7 level and MRI revealed cord compression at the C5-6, C6-7 level. ADR was performed at the C5-6, C6-7 level. After the surgery, the motor weakness of both upper extremities and paresthesia of both aspects improved. In addition, the JOA score and Nurick grade improved. A post-operative X-ray showed well positioned instruments, and post- operative MRI displayed no lesions of cord compression. Anterior cervical discectomy and fusion (ACDF) is widely accepted as a leading treatment for CSM, but ACDF may cause adjacent segment disease (ASD). We suggest that ADR also can represent a good surgical procedure for the management of multilevel spinal cord compression, as it can preserve cervical motion while avoiding ASD

Keyword

Cervical spondylotic myelopathy; Multilevel spinal cord; Anterior cervical discectomy and fusion; Artificial disc replacement; Adjacent segment disease