A Surgical Case of Spondylolysis of the Sixth Cervical Vertebra with Myelopathy

Yoshiyuki Takaishi, Satoshi Nakamizo, Takashi Mizowaki, Tsuyoshi Katsube, Yusuke Ikeuchi, Shunsuke Yamanishi, Takeshi Kondoh
2021 Spinal Surgery  
Lumbar spondylolysis is a relatively common disease that affects approximately 5% of the general population. However, cervical spondylolysis is a rare condition, with only approximately 100 cases reported to date. Herein, we report the case of a patient with cervical spondylolysis who developed myelopathy, for whom posterior decompression and circumferential fixation was performed, resulting in a good outcome. The patient was a 56-year-old male who had a history of fall after consuming alcohol
more » ... nd numbness in his right hand. His skilled upper limb movement disorder and gait disturbance had recently progressed;therefore, he was referred to our hospital. On neurological examination, quadriparesis, hyperreflexia of bilateral triceps, positive pathological reflexes(Hoffman, Trömner, and Babinski's signs) , and gait disturbance were observed. Neuroradiological findings included spondylolisthesis at C6-7, C6 spina bifida, and spondylolysis of C6 between the superior and inferior joint processes. Magnetic resonance imaging(MRI) revealed ligamentum flavum thickening at C5-6. The patient's spinal cord was highly compressed, and intramedullary high signal intensity was observed on T2-weighted imaging. Accordingly, we performed posterior decompression and circumferential fixation using C5 lateral mass and C7 pedicle screws and anterior cervical discectomy and fusion at C5-6 and C6-7. The patient's skilled upper limb movement disorder and gait disturbance improved immediately postoperatively, and his rehabilitation is ongoing.
doi:10.2531/spinalsurg.35.193 fatcat:rxlsuab75rfhnhwcl4y5zzh5uq