A case of cervical metastases in a patient with preexisting cervical
 disc replacement and fusion after 2-year symptom-free interval: when do we need
 interdisciplinary diagnostics?

Markus Melloh; Thomas Barz

doi:10.1055/s-0032-1327810

Evidence-Based Spine-Care Journal, Inhaltsverzeichnis

Evid Based Spine Care J 2012; 3(3): 51-56
DOI: 10.1055/s-0032-1327810

Case report

A case of cervical metastases in a patient with preexisting cervical disc replacement and fusion after 2-year symptom-free interval: when do we need interdisciplinary diagnostics?

Markus Melloh

¹Western Australian Institute for Medical Research, University of Western Australia

,

Thomas Barz

²Department of Orthopaedic Surgery, Asklepios Klinikum Uckermark, Schwedt/Oder, Germany

› Institutsangaben

Abstract

ABSTRACT

Recurrent cervical symptoms frequently occur after cervical disc replacement and fusion. To date, no algorithm for the diagnostic assessment of these symptoms has been established. We present a case report and review of the literature to illustrate the need for interdisciplinary diagnostics in recurrent cervicobrachialgia without pathological cervical imaging. The hospital chart, medical history, physical examination, and imaging of a single patient were reviewed. A 53-year-old man with preexisting cervical disc replacement and fusion presented with a new episode of cervicobrachialgia after a 2-year symptom-free interval. Cervical magnetic resonance imaging (MRI) showed no pathological findings. Six months later the patient reported increasing symptoms including numbness and weakness of the right arm. Repeated cervical MRI and thoracic computed tomography revealed cervical metastases with intraspinal tumor growth and an underlying extensive small cell bronchial carcinoma. In recurrent cervicobrachialgia, without pathological cervical imaging, interdisciplinary diagnostics are needed. Basic diagnostic tests may assist to exclude severe non-vertebrogenic pathologies.

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Referenzen

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