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Der Orthopäde

, Volume 48, Issue 2, pp 170–174 | Cite as

Anterior cervical corpectomy and fusion

Spinal cord compression caused by buckled ligamentum flavum
  • Lei He
  • Y. QianEmail author
Kasuistiken

Abstract

Anterior cervical corpectomy and fusion (ACCF) is a commonly performed surgical procedure for cervical spondylotic myelopathy (CSM). Various complications associated with ACCF have been reported; however, spinal cord compression caused by buckling of the ligamentum flavum (LF) after ACCF has not yet been well recognized. This article describes the case of a 59-year-old man who underwent ACCF at C5 for treatment of CSM. Although numbness and weakness of the upper extremities were relieved 2 weeks after the operation, gait imbalance persisted and worsened at 7 months. Magnetic resonance imaging (MRI) performed at 12 months revealed buckling of the LF into the spinal canal at the C5/6 level, compressing the spinal cord; moreover, high signal intensity in the spinal cord was observed beneath the buckling area on T2-weighted images. The secondary laminoplasty at C5 and C6 was performed 13 months after primary surgery and MRI showed that the spinal canal was widened at the C5 and C6 levels and the spinal cord was decompressed.

Keywords

Complication Surgery Decompression Cervical vertebrae Cervical spondylotic myelopathy 

Abbreviations

ACCF

Anterior cervical corpectomy and fusion

CSM

Cervical spondylotic myopathy

JOA

Japanese Orthopaedic Association

LF

Ligamentum flavum

MRI

Magnetic resonance imaging

PEEK

Polyetheretherketone

SVA

Sagittal vertical axis

Anteriore zervikale Korpektomie und Fusion

Myelonkompression durch Vorwölbung des Lig. flavum

Zusammenfassung

Die anteriore zervikale Korpektomie und Fusion ist eine bei zervikaler spondylotischer Myelopathie (CSM) häufig durchgeführte Operation. Verschiedene mit dieser Intervention assoziierte Komplikationen sind dokumentiert, eine nach ACCF auftretende Rückenmarkkompression durch Vorwölbung des Lig. flavum (LF) ist vielfach allerdings noch nicht bekannt. Der Artikel stellt einen 59-jährigen Patienten vor, der wegen einer CSM mit einer ACCF auf Höhe von C5 behandelt wurde. Zwei Wochen postoperativ hatten sich Taubheit und Schwäche in den oberen Extremitäten gebessert, doch die Gangstörung war zunächst unverändert geblieben und hatte sich 7 Monate postoperativ sogar verschlechtert. In der Magnetresonanztomographie (MRT) 12 Monate nach dem Eingriff zeigte sich eine Vorwölbung des LF, auf den T2-gewichteten Aufnahmen stellten sich sogar Hochintensitätsbereiche innerhalb des Rückenmarks unter dem Bereich der Vorwölbung dar. Dreizehn Monate nach dem Primäreingriff wurde eine sekundäre Laminoplastik auf Höhe C5/C6 durchgeführt. In der MRT zeigten sich danach eine entsprechende Aufweitung des Spinalkanals und eine Dekompression des Myelons.

Schlüsselwörter

Komplikation Operative Intervention Dekompression Zervikale Wirbelkörper Zervikale spondylotische Myelopathie 

Notes

Compliance with ethical guidelines

Conflict of interest

H. Lei and Y. Qian declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors. For images or other information within the manuscript which identify patients, consent was obtained from them and/or their legal guardians.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OrthopaedicsShaoxing People’s HospitalShaoxingChina

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