Case ReportTotal Disc Replacement

Anterior Cervical Foraminotomy for Radiculopathy After Cervical Artificial Disc Replacement: Technique Description and Case Report

J. Manuel Sarmiento, George Hanna, Eli M. Baron, Todd H. Lanman, Carl Lauryssen and Jason M. Cuéllar
International Journal of Spine Surgery April 2022, 16 (2) 384-392; DOI: https://doi.org/10.14444/8219

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    View of a right-sided cervical foraminotomy showing resection of the uncinate process lateral to the artificial disc implant, decompressing the corresponding nerve root.

  • Figure 2
    Figure 2

    Anterior-posterior (A) and lateral (B) cervical x-ray images showing disc collapse of C5-6 and C6-7. There was no abnormal motion during flexion (C) or extension (D) films.

  • Figure 3
    Figure 3

    Magnetic resonance images of the cervical spine showed multilevel spinal stenosis from C4-7, with C5-6 being the worst level. C4-5 had severe right and moderate left foraminal stenosis. C5-6 had disc height collapse with severe left and right foraminal stenosis. C6-7 also had disc height collapse and severe right foraminal stenosis.

  • Figure 4
    Figure 4

    Computed tomographic images of the cervical spine showed normal facet joints throughout the cervical spine, a large right foraminal osteophyte at C6-7 (A), and less extensive osteophytes at C5-6 causing right-sided foraminal stenosis (B).

  • Figure 5
    Figure 5

    Postoperative anterior-posterior (A) and lateral (B) cervical x-ray images showing appropriate placement of artificial disc replacements at C5-6 and C6-7 and right anterior cervical foraminotomy at C4-5 without hardware.

  • Figure 6
    Figure 6

    Computed tomography myelogram of the cervical spine at 12 weeks postoperatively that showed left foraminal osteophytes at C5-6 (A) and C6-7 (B).

  • Figure 7
    Figure 7

    Anterior-posterior cervical x-ray image after left anterior cervical foraminotomy was performed for new left-sided radicular symptoms at C5-6 and C6-7, demonstrating wide uncinate process resection.

Tables

  • Table

    Patient demographics and outcomes of ACF following artificial disc replacement placement.

    PatientAge, yGenderCervical Level(s) AffectedLevel of ACFImplant TypeNo. of ImplantsTime to ReoperationLaterality of Recurrent Radicular SymptomsResolution of Radicular SymptomsImplant Removed?Conversion to a Fusion?
    135MC5-6, C6-7Left C5-6, C6-7M627 moContralateralCompleteNoNo
    250MC4-5, C5-6Left C5-6M627.5 moIpsilateralPartialNoNo
    364MC5-6Left C5-6ProDisc186 moIpsilateralCompleteNoNo
    467MC5-6, C6-7Right C5-6, C6-7Prestige LP22 moIpsilateralCompleteYesa No
    568MC4-5, C5-6, C6-7Left C5-6Prestige LP39 moIpsilateralPartialNoNo

    • aC5-6 was replaced with another Prestige LP ADR.

    • ACF, anterior cervical foraminotomy.

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Anterior Cervical Foraminotomy for Radiculopathy After Cervical Artificial Disc Replacement: Technique Description and Case Report
J. Manuel Sarmiento, George Hanna, Eli M. Baron, Todd H. Lanman, Carl Lauryssen, Jason M. Cuéllar
International Journal of Spine Surgery Apr 2022, 16 (2) 384-392; DOI: 10.14444/8219
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