History
Patient is a 46 year old right hand dominant female with long-standing neck and upper extremity pain which radiated down both arms, right more than left. She also complained of numbness and tingling in both hands with weakness when attempting to lift and carry.
Pre-operative Treatment Included: Two courses of formal physical therapy, therapeutic massage, chiropractic manipulation, anti-inflammatory medications, trigger point injections, and one epidural steroid injection without relief of symptoms.
Examination
On examination she was found to have painful and restricted range of motion of her neck with measurable weakness in the biceps and forearms. Her symptoms had persisted despite non-operative treatment.
Pre-treatment MRI
MRI reveals right greater than left disc herniation and bone spur complex at C5-6.
Diagnosis
She was diagnosed with compression of the C6 nerve root which correlated with her symptoms, causing pain, numbness, and weakness.
Selected Treatment
The patient underwent a C5-6 total disc replacement (TDR).
This procedure allowed for decompression of the nerve roots with maintenance of cervical range of motion.
Outcome
Patient stayed one night in the hospital for observation and was discharged on minimal pain medications. She returned to work full time in two weeks.
Post-operative X-rays
Postoperative X-rays show the disc replacement device at C5-6 with maintenance of cervical range of motion on flexion-extension.
