P.146 Anterior spinal cord herniation following an anterior cervical discectomy and fusion: case report

Abstract

Background: Anterior cervical discectomy and fusion (ACDF) and corpectomy is one of the most common spinal operations performed worldwide to treat herniated discs causing anterior spinal cord compression , cervical spondylosis, fractures, and neoplasms, with the routine complications. There have been just a few known cases of anterior spinal cord herniation following multilevel anterior ACDF and corpectomy fusion cases. Methods: A 53-year-old male initially presented with a 3 year’s duration of increasing myelopathy with history of Anterior cervical surgery C3 -5. About 10 years prior he was not able to walk had difficulty to use his hand. (he have nice images on MRI scan of typical spinal herniation)Results: Patient was initially treated medically with utilizing analgesia and physiotherapy and gradually deteriorated over two year. Patient revision surgery and release of spinal cord with intra-operative durotomy and release of the spinal cord. He had only mild improvement in hand function, No change in legs function post operatively. Conclusions: The occurrence of spinal cord herniation through a prior ACDF or Corpectomy defect must be considered when patients present with recurrent myelopathy following anterior cervical surgery. Early investigation and early release surgery can improve the outcome for these group of patients