Quick Case: Neck Pain Persists Following ACDF


by Cat Lewis

Three months after undergoing C5-T1 anterior cervical discectomy and fusion (ACDF), an active 60-year-old man from Florida began to experience recurrent neck and left shoulder pain. In an attempt to resolve the pain and return to his daily activities, he tried physical therapy, over-the-counter medications, muscle relaxants, steroids, and epidural injections, but his pain persisted. The patient traveled to Duke to consult with Michael Haglund, MD, PhD, a neurosurgeon who specializes in cervical spine disease.

Computed tomography at Duke confirmed solid fusion at all 3 levels but incomplete fusion at C6-C7. Magnetic resonance imaging (MRI) revealed a moderate disc herniation at the C4-C5 level, and flexion-extension cervical spine plain films showed hypermobility at the same level.

Read the case conclusion here.