Revision surgery of an older patient with adjacent segment disease (ASD) following anterior cervical discectomy and fusion by PCB: A case report

Abstract

ASD of the older patients (>80 years) who have plate cage Benezech (PCB) following anterior cervical discectomy and fusion (ACDF) for a very long time is an uncommon but tough complication. Typically, the complication made patients physical limited in daily life. We present a case of a 83 year-old woman who got ASD 13 years after ACDF by plate cage Benezech (PCB) technic. She presented with 1 year of both upper and lower limbs weak and numb. The symptoms were getting worse and her muscular atrophy in hands was not controlled on follow-up even both drugs and physiotherapies were carried out. Pre-operative imaging demonstrated C2-C4 disc herniation/spinal stenosis (Fig. 7) and C4-C6 PCB prevertebral system with cervical degenerative changes and disappearance of physiological curvature. The patient elected to undergo operative management for her symptoms via a C2 partial laminectomy, and C3-C4 laminectomy with pedicle screws fixation. She was discharged home and ultimately had resolution of her presenting symptoms. A high index of efforts must remain high in the patient get ASD like the woman with PCB.

Keywords

• ASD
• ACDF
• Older patient