45 y.o. female with 3 month history worsening Left shoulder pain - PowerPoint PPT Presentation

45 y.o. female with 3 month • history worsening Left “shoulder” pain 9 years prior C5-7 ACDF • with plating at another facility Had seen several other spine • surgeons and hardware noted to be broken 4 years prior to current presentation Shoulder evaluation was • negative

CT & MRI were • obtained Previous EMG negative • Left C7 SNRB with • temporary results Consider surgical repair • for symptomatic non- union BMI 50 • Non-smoker •

75 y.o. male with 3 month • hx of left shoulder pain and weakness in LUE Mylopathic with gait • disturbance, hyper reflexic, Hoffmans reflex Motor deficit left Tricep, • Wrist Flexor and extensors Otherwise healthy with • undiagnosed ankylosing spondylitis

Admitted to Hospital • and placed in rigid Cervical collar Diagnosis of Multiple • Myeloma Consider : • • Anterior • Posterior • Anterior & posterior • XRT only

Case Presentation: Multi-Level Fusions in the Cervicothoracic Junction Colin B. Harris, MD Assistant Professor Department of Orthopaedics Rutgers – New Jersey Medical School Newark, NJ

Case • CC: Neck pain • HPI: 49 y/o F transferred from community hospital with progressive neck and upper back pain 4 months after a fall at home. Complains of both dull and sharp intermittent non-radiating pain 8/10 intensity, inability to hold head up. • PMHx: Morbid Obesity (BMI 49), no history of malignancy • PHSx: None • PE: 5/5 strength bilateral UE/LE, no focal sensory deficit, +Hoffman’s, 3 beats clonus B/L

Treatment • Patient placed in cervical tong traction for gradual kyphosis correction for 72 hours • Weight was added in 5lb increments • Staged procedure – C3-C7 ACCF – C3-T3 posterior fusion with inst.

Treatment Pathology: • – Primary breast CA – ER/PR+ – HER2+ Received radiation 4 • weeks postop Ambulatory with • preserved motor/sensory function Neck pain 2/10 • No assistive device •

CT Junction Andrew K. Simpson, MD

Patient • 60 F smoker otherwise healthy – 6 months progressive myelopathy – Predominance of upper extremity manifestations – Diffuse UE paresthesias – Motor weakness C6-T1 distributions 3/5 - 4/5 – Superimposed C6 radiculopathy – Moderate axial neck pain, secondary complaint

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