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?

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

5-6 6-7

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

Cervical Radiculopathy Cast

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

MRI: PROGRESSIVE C3/4 NARROWING, SEVER LEFT FORAMINAL STENOSIS.

DECLINED INTERVENTIONAL PAIN MANAGEMENT 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