A 45- years old carpenter presented with a 2 weeks history of severe neck pain radiating to the left middle finger. The pain worsened over days and became persistent with mild relief at rest and partially ameliorated with analgesics. Examination confirmed weakness of left elbow extensors, numbness of left hand in the C7 distribution and depressed triceps deep tendon reflex. A Magnetic Resonance Imaging of Cervical spine was requested.

 

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Magnetic Resonance Imaging confirmed a left C6-7 posterolateral disc herniation with uncovertebral region hypertrophy. In addition there was a sizeable disc herniation at C5-6 level with Ossification of the Posterior Longitudinal Ligament extending up to the middle of the C6 vertebral body.

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In view of two contiguous Cervical disc herniations (at the C5-6 and C6-7 levels) and associated OPLL, the decision of a C6 median corpectomy alongwith microdiscectomies at C5-6 and C6-7 level was performed (Image below).

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The C6 median corpectomy was replaced with a distractable implant to maintain the height of the Anterior and Middle spinal columns and further stabilizwed using a C5-C7 Anterior Cervical Plating.

The patient made an uneventful recovery and went back to his occupation after 3 weeks.