Anterior cervical discectomy and fusion for traumatic disc herniation

Abstract

A 54-year-old right-hand dominant lady presented to the emergency room after being rear-ended in a motor vehicle accident. Her only complaints were in the neck and right arm. She had severe neck pain that radiated down the back of her right arm. She had dense numbness in the right C7 distribution and also has marked weakness in the right triceps. The biceps, triceps, and brachioradialis reflexes were all hyperactive on both sides. Hoffman's sign was positive in both hands. Her plain radiographs of the cervical spine, including besteffort flexion-extension views, revealed no fractures or instability. However, there was a degenerated disc space at C6-7 with bony osteophyte formation both anteriorly and posteriorly into the canal (Fig. 14.1). A computed tomography scan without contrast in the emergency room revealed the same, but with indications of a disc herniation into the canal as well. An MRI was ordered to get a better view of the spinal canal (Figs. 14.2 and 14.3). This showed a very large disc herniation at C6-7, right-sided, causing central canal stenosis in addition to foraminal stenosis. © 2010 Springer-Verlag Berlin Heidelberg.