Tobing S Dohar, Aprianto Petrus
Department of Orthopaedic & Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Jakarta Pusat, Jakarta 10430, Indonesia.
Ann Med Surg (Lond). 2020 Dec 3;60:708-713. doi: 10.1016/j.amsu.2020.11.064. eCollection 2020 Dec.
In managing cervical disc herniation, several treatment options are available. Anterior cervical decompression and fusion (ACDF) remain the gold standard in symptomatic cervical disc herniation. However, multilevel ACDF could diminish the motion of the segment. We planned to salvage the movement by only using single-level ACDF in our patient and osteophyte removal to reduce compression caused by spurs formation related to the herniated nucleus.
A male patient, 43 years old, came with a chief complaint of neck pain three months ago. The pain was intermittent, radiated into both hands. There was midline tenderness, and his sensation was decreased from the level of C5 below. We managed to diagnose the patient with Cervical Herniated Disc (CHD) using MRI and performed single-level ACDF.
After the operation, osteophyte formation was safely removed, the pain and the tingling sensation was no longer felt. The VAS score was reduced from 4 to 1. We observed good spinal fusion in the post x-ray imaging.
Anterior cervical discectomy and fusion after osteophyte removal proved successful for our patient treatment, with improvement from neck and arms symptoms. However, longer-term evaluation needs to be planned further to assess the result and possible complications of single-level ACDF.
在处理颈椎间盘突出症时,有多种治疗选择。颈椎前路减压融合术(ACDF)仍是有症状的颈椎间盘突出症的金标准。然而,多节段ACDF可能会减少节段的活动度。我们计划在患者中仅采用单节段ACDF并去除骨赘,以减轻由与突出髓核相关的骨赘形成所导致的压迫,从而挽救节段活动度。
一名43岁男性患者,三个月前因颈部疼痛为主诉前来就诊。疼痛为间歇性,放射至双手。有中线压痛,自C5水平以下感觉减退。我们通过磁共振成像(MRI)诊断该患者为颈椎间盘突出症(CHD),并实施了单节段ACDF。
术后,骨赘形成被安全去除,疼痛和刺痛感消失。视觉模拟评分(VAS)从4分降至1分。在术后X线影像中观察到良好的脊柱融合。
对于我们的患者,去除骨赘后行颈椎前路椎间盘切除融合术治疗成功,颈部和手臂症状得到改善。然而,需要进一步规划长期评估,以评估单节段ACDF的结果及可能的并发症。