AW Left Cervical Radiculopathy Presentation World class swimmer - PowerPoint PPT Presentation

AW Left Cervical Radiculopathy

Presentation • World class swimmer with left scapular pain radiating into long finger. • 3/5 left Triceps and 4/5 left grip. • Unable to train due to pain and weakness.

Initial X-rays

5-6 6-7

Options? 5-6 • Non-surgical care • 2-Level ACDF: • Graft options? (Allo, Auto, BMP-2) • Foraminotomies • Laminoplasty • 2-Level CDR 6-7

Cervical Radiculopathy Cast Gregory D. Schroeder, MD Assistant Professor, Orthopaedic Surgery The Rothman Institute at Thomas Jefferson University

Case • 31 year old with chief complaint of 6 months of left arm pain • Police office and boxer • Physical Exam • 4+ Biceps • Otherwise normal

Case

Case

Case C3/4 C4/5 C4/5

Case C5/6

Case • OR Options • ACDF • CDA • Foraminotomy • Laminoplasty • PCF

Case

Thank You

Cervical Radiculopathy Mark F. Kurd, MD Associate Professor, Department of Orthopaedics Thomas Jefferson University The Rothman Institute

• 69 yo male • Symptoms – Six months L peri-scapular and arm pain, – L hand dysesthesias – Worse with extension when riding bike • Tx: – PT, ESI: minimal benefit • PE: – 4/5 L Tricep – Dec sensation L C7 dermatome – Pos L Spurlings

60y.o. male 2 month history worsening left neck, shoulder and arm pain to the elbow PMH: NIDDM, HTN, non- smoker 10 years prior C5/6-C6/7 ACDF’s with plating using allograft rings and autogenous iliac cancellous bone. SH: Small business owner as Financial Planner, active hiker/camper My accountants brother Treatment: NSAIDs, short course of PT Symptoms progressed

DECLINED INTERVENTIONAL PAIN MANAGEMENT MRI: PROGRESSIVE C3/4 NARROWING, SEVER LEFT FORAMINAL STENOSIS. ELECTED SURGICAL REMEDY

 42 year old female athlete competing in extreme sport challenges (Tough Mudders)  Severe right upper extremity pain, tricep weakness and numbness  No improvement with meds and PT  MRI shows Large C6-7 HNP with stenosis