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Postoperative Shingles Mimicking Recurrent Radiculopathy after Anterior Cervical Diskectomy and Fusion.

Montgomery JT, Lawrence BD, Brodke DS, Patel AA - Global Spine J (2015)

Bottom Line: The study required no outside funding.The study authors have no financial interest in any of the products or techniques discussed.The patient, however, developed postherpetic neuralgia and remained symptomatic at her 2-year postoperative visit.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States.

ABSTRACT
Study Design Case report and review of literature. Objective To report the case of a 67-year-old woman who developed delayed onset (6 months) of symptomatic shingles after cervical nerve root decompression in a previously symptomatic dermatome. Methods The patient's clinic course and outcomes were retrospectively reviewed. The study required no outside funding. The study authors have no financial interest in any of the products or techniques discussed. Results The patient received definitive treatment for shingles once the zoster form rash manifested. The patient, however, developed postherpetic neuralgia and remained symptomatic at her 2-year postoperative visit. Conclusions Although shingles is a common disease state affecting patients in the fifth and sixth decades of life, it is rarely seen in the setting of cervical nerve root decompression. This case demonstrates the need to include shingles on the differential diagnosis of recurrent neurogenic pain after anterior cervical decompression and fusion.

No MeSH data available.


Related in: MedlinePlus

Preoperative T2-weighted sagittal magnetic resonance imaging clearly demonstrating a large disk-osteophyte complex at the C5–C6 level.
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FI1400012cr-1: Preoperative T2-weighted sagittal magnetic resonance imaging clearly demonstrating a large disk-osteophyte complex at the C5–C6 level.

Mentions: Imaging, including plain films and magnetic resonance imaging (MRI), were obtained demonstrating C5–C6 and C6–C7 spondylosis with corresponding central and neuroforaminal cervical stenosis. Based on her history, physical examination, and imaging studies, the patient was diagnosed with cervical spondylotic myeloradiculopathy (Fig. 1, Fig. 2). Her symptoms were recalcitrant to thorough nonoperative treatment, and she underwent surgical management with anterior cervical decompression and fusion at C5–C6 and C6–C7. Her radicular symptoms completely resolved and her myelopathic symptoms improved significantly in the immediate postoperative period. The patient was discharged from the hospital on postoperative day 1. Plain radiographs demonstrated acceptable instrumentation position and alignment without evidence of complications (Fig. 3). By her 3-month examination, the patient had complete resolution of axial, radicular, and myelopathic symptoms. Left upper extremity examination demonstrated intact 5/5 strength in all muscle groups, intact sensation to light touch, and 2-point discrimination as well as a negative Hoffman sign and symmetric reflexes.


Postoperative Shingles Mimicking Recurrent Radiculopathy after Anterior Cervical Diskectomy and Fusion.

Montgomery JT, Lawrence BD, Brodke DS, Patel AA - Global Spine J (2015)

Preoperative T2-weighted sagittal magnetic resonance imaging clearly demonstrating a large disk-osteophyte complex at the C5–C6 level.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4472289&req=5

FI1400012cr-1: Preoperative T2-weighted sagittal magnetic resonance imaging clearly demonstrating a large disk-osteophyte complex at the C5–C6 level.
Mentions: Imaging, including plain films and magnetic resonance imaging (MRI), were obtained demonstrating C5–C6 and C6–C7 spondylosis with corresponding central and neuroforaminal cervical stenosis. Based on her history, physical examination, and imaging studies, the patient was diagnosed with cervical spondylotic myeloradiculopathy (Fig. 1, Fig. 2). Her symptoms were recalcitrant to thorough nonoperative treatment, and she underwent surgical management with anterior cervical decompression and fusion at C5–C6 and C6–C7. Her radicular symptoms completely resolved and her myelopathic symptoms improved significantly in the immediate postoperative period. The patient was discharged from the hospital on postoperative day 1. Plain radiographs demonstrated acceptable instrumentation position and alignment without evidence of complications (Fig. 3). By her 3-month examination, the patient had complete resolution of axial, radicular, and myelopathic symptoms. Left upper extremity examination demonstrated intact 5/5 strength in all muscle groups, intact sensation to light touch, and 2-point discrimination as well as a negative Hoffman sign and symmetric reflexes.

Bottom Line: The study required no outside funding.The study authors have no financial interest in any of the products or techniques discussed.The patient, however, developed postherpetic neuralgia and remained symptomatic at her 2-year postoperative visit.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States.

ABSTRACT
Study Design Case report and review of literature. Objective To report the case of a 67-year-old woman who developed delayed onset (6 months) of symptomatic shingles after cervical nerve root decompression in a previously symptomatic dermatome. Methods The patient's clinic course and outcomes were retrospectively reviewed. The study required no outside funding. The study authors have no financial interest in any of the products or techniques discussed. Results The patient received definitive treatment for shingles once the zoster form rash manifested. The patient, however, developed postherpetic neuralgia and remained symptomatic at her 2-year postoperative visit. Conclusions Although shingles is a common disease state affecting patients in the fifth and sixth decades of life, it is rarely seen in the setting of cervical nerve root decompression. This case demonstrates the need to include shingles on the differential diagnosis of recurrent neurogenic pain after anterior cervical decompression and fusion.

No MeSH data available.


Related in: MedlinePlus