title: Recurrence of cervical myelopathy secondary to a strut graft fracture 20 years after anterior decompression and fusion: a case report.
abstract: This study reports on a 70-year-old man with recurrent cervical myelopathy 20 years after anterior decompression and fusion of C4-7 using a free vascularised strut graft. The recurrent myelopathy was secondary to a kyphotic deformity of a fractured graft and residual ossification of the posterior longitudinal ligament with stenosis at C3/4. Intraoperative spinal cord-evoked potentials indicated that spinal cord traction secondary to progressive kyphosis of the cervical spine after the graft fracture was the cause. The patient underwent laminoplasty at C3 and laminectomy at C4 to decompress the stenosis at C3/4 as well as posterior cervical spinal fusion at C3-7 with pedicle screws and a lateral mass screw and a bone graft to prevent further progression of the kyphosis. At postoperative 18 months, the patient's Japanese Orthopaedic Association score had improved to 14 from 8, and he could walk without support.
authors: Department of Orthopaedic Surgery, Kochi Medical School, Kochi, Japan.
authors: Kazunobu
authors: K
authors: Kida
authors: Shogo
authors: S
authors: Takaya
authors: Nobuaki
authors: N
authors: Tadokoro
authors: Masashi
authors: M
authors: Kumon
authors: Katsuhito
authors: K
authors: Kiyasu
authors: Tomonari
authors: T
authors: Kato
authors: Ryuichi
authors: R
authors: Takemasa
authors: Masahiko
authors: M
authors: Ikeuchi
authors: Toshikazu
authors: T
authors: Tani
mesh_terms: D000368:Aged; D016025:Bone Transplantation / Q000009:adverse effects*; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D018450:Disease Progression; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D013118:Spinal Cord Diseases / Q000209:etiology / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications* / Q000601:surgery; D017211:Treatment Failure
keywords: ossification of posterior longitudinal ligament; spinal cord diseases