Performance of Cervical Arthroplasty at a Pseudarthrosed Level of a MultiLevel Anterior Cervical Discectomy and Fusion: Case Report. Issue 6 (1st June 2016)

• Record Type: Journal Article
• Authors: Spinelli, Joseph; Neal, Christopher J.; Rosner, Michael K.
• Is Part Of: Military medicine. Volume 181:Issue 6(2016)
• Page Start: e621
• Page End: e624
• Publication Date: 2016-06-01
• Subjects: Surgery, Military -- Societies, etc; Medicine, Military -- Societies, etc; Medicine, Military -- Periodicals; Surgery, Military -- Periodicals; Medicine, Military; Surgery, Military; Military Medicine -- Periodicals; Periodicals; Electronic journals; 616.98023
• DOI: 10.7205/MILMED-D-15-00322
• Languages: English
• ISSNs: 0026-4075

Abstract

ABSTRACT: Objective: To present a conversion from an anterior cervical discectomy and fusion (ACDF) to cervical arthroplasty in a 40-year-old, active duty member and perform a review of the literature. Methods: A helicopter pilot in the U.S. Army underwent a three-level ACDF in 2010 at a nonmilitary institution for symptoms of bilateral upper-extremity radiculopathy. His symptoms resolved; however, per regulations, he was grounded. The patient recently presented at our clinic for evaluation of axial neck and intrascapular pain with radiographic evaluation revealing pseudarthrosis at C6-7 with segmental motion without facet joint degeneration. Surgery was performed to remove the existing allograft and replace it with an artificial disc, thus restoring a motion segment. Results: Postoperative imaging reveals appropriate placement of the artificial disc and range of motion at C6-7 with the patient reporting improvement in neck pain. He has since been granted a waiver to return to active flight status. Conclusions: Revision of ACDF to arthroplasty is an exceedingly rare procedure with only two cases reported in the literature. Here, the authors demonstrate use of the procedure for a military career-specific application. When facet joint degeneration or ankylosis is absent, restoration of motion can successfully, and safely, be achieved.