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Case Study: Multilevel Anterior Fusion for Kyphosis
A 60 year old female presented with nearly a year of progressive neck pain. She developed some pain and tingling into her arms and hands with tipping her head to either side. Her main complaint was positional neck pain, associated with a cracking sound. She had exhausted her conservative options, including PT, chiropractic, NSAIDs, and steroids. Cervical steroid injections provided relief for a matter of weeks. Her MRI did show disc herniations and bone spurs resulting in spinal canal stenosis. Her spinal cord was compressed, and on physical exam, she showed signs of a myelopathy. However, her cervical xrays showed a reversal of normal cervical stenosis and development of kyphosis. Given the mechanical degeneration in her cervical spine, a multilevel anterior fusion was recommended.
With 13 degrees of kyphosis, the use of lordotic cages and a custom bend to the anterior plate allowed us to recreate her normal lordosis. This lessened the structural stress on the adjacent segments, and alleviated her chronic neck pain. Pressure on the spinal cord was also corrected during the discectomies.
The patient was required to wear a cervical collar for 3 months, which she tolerated very well. She was then started in PT for range of motion and stabilization exercises. She has done very well since surgery.