Cervical stenosis in a patient with arthrogryposis: case report.
Study Design Case report. Objective Amyoplasia-type arthrogryposis is a rare congenital disease that presents as multiple contractures involving various areas of the body. To the authors' knowledge, there have been no reports of adults with amyoplasia in the current literature. We report a case of an adult patient with cervical stenosis in the setting of amyoplasia. Patients and Methods A 48-year-old patient with amyoplasia and over 30 previous orthopedic reconstructive surgeries presented with neck pain radiating down his left shoulder and into the fingers, dysesthesia in his fingertips, and left-sided periauricular headache. A diagnosis of central spinal canal stenosis and bilateral foraminal stenosis at C3-C7 with radiculopathy was made based on computed tomography scans. Because of a prior right-side sternocleidomastoid muscle transfer, a left-side C3-C4, C5-C7 anterior cervical discectomy and fusion procedure was performed. Results The patient experienced significant improvement in symptoms that was transient. Symptoms returned to preoperative values after 1 year, despite significant and persistent improvement in stenosis. Conclusions Both amyoplasia and cervical stenosis can manifest in neurologic symptoms. Distinguishing the causing pathology can be challenging. The radiographic improvement of cervical stenosis in a patient with amyoplasia is not always associated with long-standing pain relief.
Weill Cornell Medical College, New York, New York, United States.
Jerry
J
Du
Department of Spine and Scoliosis Surgery, Hospital for Special Surgery, New York, New York, United States.
Alexander
A
Aichmair
Department of Spine and Scoliosis Surgery, Hospital for Special Surgery, New York, New York, United States.
Marios
M
Lykissas
Weill Cornell Medical College, New York, New York, United States ; Department of Spine and Scoliosis Surgery, Hospital for Special Surgery, New York, New York, United States.
Federico
F
Girardi
arthrogryposis; cervical stenosis