• Title/Summary/Keyword: Anterior cervical discectomy and fusion, Case report

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Integrative Korean Medicine Treatment for Pain after Anterior Cervical Discectomy and Fusion: A Case Report

  • Taewook Lee;Jihun Kim;Soo Kwang An;Yoona Oh;Kun Hyung Kim;Gi Young Yang;Eunseok Kim
    • Journal of Acupuncture Research
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    • v.41
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    • pp.191-196
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    • 2024
  • Anterior cervical discectomy and fusion (ACDF) is commonly used to treat cervical radiculopathy by decompressing and stabilizing the spine, but complications such as postoperative pain and adjacent-level disc degeneration remain. This report presents a case of a patient with persistent right arm pain after ACDF for a herniated disc at C5/6 and congenital ankylosis at C6/7. The patient experienced severe pain managed with painkillers, which initially worsened but improved significantly with integrative Korean Medicine treatment, including pharmacopuncture, acupotomy, acupuncture, cupping, and herbal medicine. Pain levels decreased from a Numerical Rating Scale of 8 to 3, and the Neck Disability Index improved from 19 to 8, enhancing fine motor skills like handwriting. This case suggests the potential of integrative Korean Medicine in improving recovery post-ACDF and highlights the need for further research despite limitations in generalizability due to the single-case study format.

Emergent Endovascular Embolization for Iatrogenic Vertebral Artery Injury during Cervical Discectomy and Fusion

  • Jung, Hyeun-Jin;Kim, Dong-Min;Kim, Seok-Won;Lee, Sung-Myung
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.520-522
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    • 2011
  • Injury to the vertebral artery during anterior cervical discectomy is rare but potentially fatal. We report a case of cerebellar infarction after endovascular embolization for iatrogenic vertebral artery injury at C5-C6 during an anterior cervical discectomy and fusion. A 61-year-old man had an intraoperative injury of the right vertebral artery that occurred during anterior cervical discectomy and fusion at C5-C6. Hemorrhage was not controlled successfully by packing with surgical hemostatic agents. While the patient was still intubated, an emergency angiogram was performed. The patient underwent endovascular occlusion of the right V2 segment with coils. After the procedure, his course was uneventful and he did not show any neurologic deficits. Brain computed tomographic scans taken 3 days after the operation revealed a right cerebellar infarction. Anti-coagulation medication was administered, and at 3-month follow-up examination, he had no neurologic sequelae in spite of the cerebellar infarction.

Cervicothoracic Spinal Epidural Hematoma after Anterior Cervical Spinal Surgery

  • Lee, Dong-Yeob;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.541-543
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    • 2010
  • The purpose of this case report is to describe a rare case of a cervicothoracic spinal epidural hematoma (SEH) after anterior cervical spine surgery. A 60-year-old man complained of severe neck and arm pain 4 hours after anterior cervical discectomy and fusion at the C5-6 level. Magnetic resonance imaging revealed a postoperative SEH extending from C1 to T4. Direct hemostasis and drainage of loculated hematoma at the C5-6 level completely improved the patient's condition. When a patient complains of severe neck and/or arm pain after anterior cervical spinal surgery, though rare, the possibility of a postoperative SEH extending to non-decompressed, adjacent levels should be considered as with our case.

Bacterial Meningitis Complicated by Myelitis Following Anterior Cervical Spinal Surgery (전방 경추 수술 후 발생한 세균성 뇌수막염과 동반된 척수염)

  • Ham, Dong-Hun;Choi, Byeong-Yeol;Jung, Myung-Cheol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.519-524
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    • 2021
  • Meningitis after spinal surgery occurs rarely but can be fatal. A 49-year-old male was diagnosed with compressive myelopathy due to cervical disc herniation at the C 5, 6 level and underwent anterior cervical discectomy and fusion (ACDF). He complained of severe neck pain and stiffness with fever postoperatively and one week after surgery, the patient presented with abrupt tetraplegia. The follow-up magnetic resonance imaging and cerebrospinal fluid analysis revealed bacterial meningitis complicated by myelitis. The patient was treated with antibiotics and steroid, but the outcome was poor. The authors report a case of meningitis combined with myelitis following anterior cervical spinal surgery.

Management of Traumatic C6-7 Spondyloptosis with Cord Compression

  • Choi, Man-Kyu;Jo, Dae-Jean;Kim, Min-Ki;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.289-292
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    • 2014
  • A case of total spondyloptosis of the cervical spine at C6-7 level with cord compression is described in a 51-year-old male. Because the bodies of C6 and 7 were tightly locked together, cervical traction failed. Then the patient was operated on by a posterior approach. Posterior stabilization and fusion were performed by C4-5 lateral mass and C7-T1 pedicle screw fixation and rod instrumentation with bridging both C4-5's rods to the C7-T1's extended ones. After C6 total laminectomy and foraminotomy, the C6 body was returned to its proper position. Secondly, anterior stabilization and fusion were performed by C6-7 discectomy with a screw-plate system. A postoperative lateral plain radiograph showed good realignment. In this case, we report the clinical presentation and discuss the surgical modalities of C6-7 total spondyloptosis and the failed close reduction.

Acute Paraplegia Following Lumbar Puncture in a Patient with Cervical Disc Herniation - Case Report - (경추간판탈출증 환자에서 요추천자후에 발생한 급성 양하지마비 - 증례보고 -)

  • Doh, Jae-Won;Hwang, Sun-Chul;Yun, Suck-Man;Bae, Hack-Gun;Lee, Kyeong-Seok;Yun, Il-Gyu Yun;Choi, Soon-Kwan;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.1042-1046
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    • 2001
  • The incidence of paraplegia following drain of cerebrospinal fluid(CSF) by lumbar puncure below a spinal block is rare, and most of them occurred in spinal tumor. We report a case of acute paraplegia following lumbar puncture for computed tomography myelography(CTM) in a 42-year-old man who sustained a cervical disc herniation. Four hours after lumbar puncture for CTM, sudden paraplegia was developed. After emergent anterior cervical discectomy and fusion with cervical plating, the patient recovered completely. To the authors' knowledge, this is the first case of spinal shock complicating lumbar puncture for routine myelography in a patient with cervical disc herniation. The prompt recognition of this unusual complication of lumbar puncture may lead to good clinical outcome. Instead of CTM requiring lumbar puncture, MRI should be considered as the initial diagnostic procedure in a patient of cervical disc herniation associated with myelopathy. We discuss the possible mechanisms of acute paraplegia following lumbar puncture with literature review.

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