Case study: ADDplus^TM

Corpectomy C5 and C6 and vertebral body replacement for stenosis and myelopathy

Prof. Dr. Ulrich Hubbe, Senior Physician, Head of Spine Therapy Section, Department of Neurosurgery, University Hospital Freiburg (Created in 2014)

"We used the ADDplus for the vertebral body replacement. This expandable titanium vertebral body replacement is equipped with plates cranially and caudally which fulfill the function of an anterior plate. This shortens not only the surgical time but also forms a particularly solid construction. Dislocation of the vertebral body replacement dorsally into the spinal canal is thus ruled out."

Prof. Dr. Ulrich Hubbe, Senior Physician, Head of Spine Therapy Section, Department of Neurosurgery, University Hospital Freiburg

Symptoms
The 66-year-old male patient presented due to a gait disturbance that had been accentuated for 2 weeks and which was known to be slowly increasing for 2-3 years. He was no longer freely ambulatory. Motor function examination revealed distal arm paresis more pronounced on the right, non-radicular dysesthesia of the left arm, no paresis or sensitivity deficits of the lower extremities but marked ataxia with dysdiadochokinesis and increased reflexes of the lower extremities. MRI for the suspicion of cervical myelopathy.

Diagnosis
The MRI demonstrated high-grade degenerative spinal canal stenosis of C4-7 with compression of the already somewhat atrophic spinal cord as well as intramedullary spinal accentuation in T2 weighting as signs of myelopathy. The CT demonstrated extensive stenosis of the cervical spine due to dorsal osteophytes at the level of C4/5, C5/6 and C6/7 and ligamentous narrowing. In view of the myelopathy seen clinically and on imaging, an indication was made for a more extensive decompression of the cervical spinal canal. This should be achieved from the anterior direction via a corpectomy of C5 and C6 and vertebral body replacement implant with expandable screws.

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