80 year old male who was previously highly active and healthy presents to the emergency room with neurologic decline starting 2-3 weeks prior with rapid further deterioration following two falls one day prior. The weakness is mostly in the hands and arm and he is not able to perform activities of daily living as well as recreation.
The weakness is associated with neck pain and inability to ambulate with stability. On examination there was weakness in the hand grip as well as arms. There was no weakness in the legs but the patient was grossly off balance. There was some sensory deficit also in her left arm. The tone of the muscles in all four limbs was also increased.
MRI T2 image Mid-Sagittal cut showing severe spinal cord stenosis and compression at C3-4 and C 5-6 with degenerative joint disease of Cervical spine
MRI T2 image Axial cut showing severe spinal cord stenosis and compression at C3-4
MRI T2 image Axial cut showing severe spinal cord stenosis and compression at C3-4
X rays Lateral view of C spine showing advanced degenerative Cervical spine disease
Anterior Cervical Discectomy and Fusion was performed to relieve the pressure from the spinal cord with cleaning to disc and fusion using bone graft and plate and screws from the front.
The surgery was performed from the front of the neck. The disc space is cleaned up to the back and all the pressure from over the spinal cord was removed. The patient had improvement in postoperative period and that improvement continued to happen over the next few months. He was sent to the rehab facility from where he was discharged to home
