Anterior Cervical Diskectomy And Fusion With Autogenous Iliac Crest Graft Enhanced By Anterior Plate System For Cervical Spondylotic Myelopathy

A 50-year-old man was admitted to hospital with 6 months bilateral legs weakness in May 2003.Six months prior to his admission,he developed weakness and was unable to weight bear with gait disturbances. His symptoms were associated with arm and neck pain.He did not receive any treatment.He had otherwise maintained good general health .Physical examinations but nervous system revealed no special.The palpable pain of C4 -C6 intervertebral gap was obvious.Neurological examination revealed complete sensory loss in the distal index and middle finger of left hand.The deep tendon reflexes of bilateral biceps brachii and triceps brachii were hyperreflexic . Bilateral Hoffmann'sign were positive.The Muscle strength of bilateral biceps brachii and triceps brachii was graded Grade 4. Abdominal, cremasteric and perineal reflexes were hyporeflexic.The regions of perineal and the lower extremities revealed hypoesthesia.The tension of the lower extremities was high.The patellar clonus and ankle clonus of right leg were seen.The muscle strength of bilateral quadriceps femoris was graded Grade 4. Babinski'sign was positive.laboratory examinations were negative.Abdominal ultrasound was normal.The x-ray films showed that the intervertebral space of C5 and C6 was narrow with osteophytes.Megnetic resonance imaging (MRI)demonstrated C5 C6 disc protrusion .Therefore the patient was diagnosed as cervical spondylosis myelopathy.An operation of anterior cervical diskectomy and fusion with autograft enhanced by anterior titanium plate system was performed.Arm pain had gone on awaking ,and neck pain during hospitalization .The patient was reviewed 6 months after the surgery .No pains in the arms and right iliac crest. Bilateral legs weakness was dispeared .X-ray postoperative 6 months had a good fusion with new bone formation at the graft-endplate junction. The x-ray films also demonstrated that the height of the intervertebral space and the lordosis of the cervical spine had been restored .Plate and screws were found neither broken nor loosed.