As a clinical case, there’s an 80 year old male who is active and healthy, presents with clumsiness, has a fall, neurological status declining since two to three weeks, and then suddenly increased neurological deterioration following fall.
Patient has upper extremity symptoms, essentially weak on deltoids, clumsiness in the hands and the lower extremities are 5/5. So this presentation is essentially a central cord syndrome presentation. This is very typical of a degenerative cervical spine who have underlying cervical stenosis and they have a fall. It’s developed instability causing a pinch on the spinal cord, and the MRIs will usually show us the stenosis.
This patient essentially has a two-level stenosis, C3-4 and C4-5. What we did was anterior cervical decompression & fusion. So these patients can be treated from front and from back, depending on the criteria they meet, the number of levels that are involved, how the kyphosis is, how they work.
So this patient was a candidate for anterior cervical decompression and fusion. ACDF is one of our very good surgeries, safe surgery. It restores the anatomy very well. We do fusion in that, which has its own drawbacks, but we are able to get the best lordosis on the cervical spine from such a procedure.
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