Evaluation of sagittal alignment and range of motion of the cervical spine using multi-detector- row computed tomography in asymptomatic subjects

Revolutionizing Relief: Cervical Radiculopathy With Neurological Deficits Rescued by Cervical Disc Replacement

Cervical radiculopathy is a common condition characterized by neck pain radiating to the upper and lower limbs, often accompanied by tingling sensations, numbness, and weakness. We present the case of a 32-year-old male who presented with left-sided cervical radiculopathy and neurological deficits. Clinical examination revealed left C5/C6/C7 hypoesthesia, diminished grip strength, reduced power in the left upper and lower extremities, and a positive Spurling test. Magnetic resonance imaging (MRI) of the cervical spine revealed multilevel cervical disc herniations at C4-C5 and C5-C6 levels, resulting in stenosis. The patient underwent anterior cervical discectomies with artificial disc replacement (cervical disc arthroplasty (CDA)) at the C5-C6 level. The surgical procedure was uneventful, and the patient experienced prompt relief from neurological symptoms within two weeks postoperatively. Follow-up radiographs at one week post-surgery demonstrated a preserved range of motion at each operated level with the artificial disc in situ. This case highlights the successful management of cervical radiculopathy with neurological deficits using anterior cervical discectomy and artificial disc replacement. The timely intervention led to the resolution of symptoms and restoration of function, demonstrating the efficacy of this surgical approach in alleviating radicular symptoms and preserving cervical spine mobility. Further studies and long-term follow-up are warranted to validate the long-term outcomes and durability of artificial disc replacement in such cases.

A Potentially Advantageous Use of a Zero-Profile, Stand-Alone Anterior Interbody Spacer at C2-3 for the Treatment of Hangman's Fracture: A Technical Case Report

Hangman’s fracture or traumatic spondylolisthesis of the axis is a common fracture pattern in the cervical spine. Nonoperative management with an external orthosis is appropriate in select cases. However, when surgery is necessary, both anterior and posterior approaches can be used, and the optimal approach has not been established. Anterior discectomy and fusion with plating at C2-3 may cause dysphagia from plate prominence, while the posterior fusion of C1-3 eliminates motion of an otherwise healthy atlantoaxial joint, resulting in a significant loss of cervical range of motion. We describe the first published application of a stand-alone, zero-profile implant at the C2-3 segment to treat Hangman’s fracture, a technique already successfully used in the C3-7 region for trauma and degenerative applications. A stand-alone, zero profile interbody spacer was employed in anterior C2-3 arthrodesis surgery for Hangman’s fracture in a 61-year-old female following failure of healing after three months in a hard cervical collar. Late postoperative imaging showed successful fusion and the patient had favorable clinical results with relief of neck pain. A zero-profile, stand-alone implant at C2/3 is an attractive option to surgically treat C2 Hangman’s fracture, potentially minimizing dysphagia attributable to an anterior plate and spare the atlantoaxial joint that is fused with C1-3 posterior arthrodesis. The benefits of the application of this technique may be validated with additional studies.