Anterior Cervical Discectomy And Fusion In The Management Of Cervical Radiculopathy

Case Report And Review Of Literature

Abstract

Cervical radiculopathy is a condition characterized by severe neck and arm pain, often due to nerve root or spinal cord compression. This case report details the management of a 63-year-old man who presented with one month of debilitating unilateral cervical radiculopathy in the left arm, unresponsive to pharmacological therapy. Magnetic resonance imaging (MRI) revealed a left paracentral disc herniation at C5-C6 with spinal cord compression. Given the failure of conservative treatments and the presence of significant neurological compression, anterior cervical discectomy and fusion (ACDF) was selected as the surgical intervention of choice. ACDF is fittingly recognized as the gold-standard procedure for managing symptomatic cervical disc herniations, particularly in cases with spinal cord compression. The approach allows for direct decompression of the spinal cord and nerve roots while providing immediate spinal stabilization. In this case, fine microsurgical techniques were employed, utilizing magnification and high-quality lighting to navigate the deep anterior cervical spine anatomy. The herniated disc was carefully excised, and a cervical interbody fusion with a PEEK cervical cage was performed to maintain spinal alignment and aid in restoring cervical lordosis.

Postoperatively, the patient experienced complete resolution of radicular pain andregained full range of motion without complications. This case underscores the critical role of a thorough understanding of cervical spinal anatomy and the application of refined microsurgical techniques in ensuring optimal outcomes. Proper visualization, enabled by magnification and good lighting, is essential in preserving critical structures, such as the dura and its attendant neurological structures during the procedure. Minimal tissue disruptions ensure quick post-operative recovery in a majority of cases. In Conclusion, ACDF remains the gold standard for addressing cervical disc herniations with cord compression, combining direct decompression and stabilization, while the success of the surgery depends on the surgeon's expertise in cervical anatomy and microsurgical precision.