Thursday, September 6, 2007

Correcting painful C7-T1 spondylolisthesis below previous long cervical fusion using anterior cervical discectomy and plate (ACDF)

This woman had a multi-level cervical fusion done years ago, and then a C34 ACDF done a couple years ago.
Over past year, she has developed severe neck and bilateral arm pain, and actually has to support her head using her hands for relief.
Her X-Rays show a severe spondylolisthesis at C7T1 at bottom of her neck, where C7 is slipping forward on T1, where disc and facet joints have worn out, and exiting nerve roots are being pinched bilaterally.
I fixed this yesterday morning by doing an anterior approach on C7T1, jacking open the C7T1 space and removing the remaining disc and osteophytes, taking pressure off spinal cord and nerve roots, then inserting a small bone wedge of allograft to replace the disc. After this, I fastetened a titanium plate, and closed up the wound with a plastic surgery subcuticular closure with dermabond.
Yesterday afternoon she was walking around the halls of the Duke Raleigh Hospital in a soft collar with excellent pain relief, no longer needing to hold her head up! She goes home this morning, a happy camper.

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