Board Certified Neurosurgeon Brain & Spine Care 860-889-9035
Mark Hornyak, MDBoard Certified Neurosurgeon
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Spine Case

Cervical Fusion

85 year old man presents with shock-like sensations shooting into his arms and hands Increasing numbness in hands One month of hand and arm weakness, getting worse rapidly Off balance walking Can’t use his hands for fine motor tasks like shaving, buttoning clothes etc.

Description

Musculoskeletal exam with limited motion of cervical spine
Neurological examination with weakness and loss of sensation in hands
Abnormal and hyperactive reflexes

Gallery

Images

Figure 1CT c-spine (sagittal left, axial right) performed in ER about 1 week prior to presentation due to fall. Note the degenerative changes and stenosis.
Figure 2MRI c-spine (sagittal left, axial right) also demonstrating the degenerative changes. There is a bright spot in the spinal cord (T2 signal change) at the C3/4 level (arrow).
Figure 3Images from intraoperative fluoroscope acquired in the lateral plane. The first image (left) shows the placement of a localizing needle into the C4/5 disc space. The second (right) shows the implants in place at the completion of the procedure.
Figure 4Image acquired from the surgical microscope. It shows interbody biomechanical devices (aka cages or spacers) at the levels where the discs have been removed.
Figure 5Postoperative x-rays showing the devices in place in the lateral (left) and AP (right) planes.
Figure 6CT c-spine (sagittal left, axial right) acquired about 9 months after his surgery. It shows bone growth around the interbody devices (cages)
Figure 7Diagram demonstrating the interbody biomechanic device that was employed in this particular procedure. The device is the Stalif-C FLX by Centinel Spine.

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