PMC6402219_01
(a) X-ray of the cervical spine obtained just before the initial surgery showed destructive changes of the cervical spine, with a C2-7 lordotic angle of 0 . (b) Sagittal T2-weighted MRI of the cervical spine performed just before the initial surgery showed multisegmental stenosis at the C3/4, C4/5, C5/6, and C6/7 disc levels.
CRIOR2019-7062568.001.jpg
PMC6402219_01_CRIOR2019-7062568.001.jpg
fig1
CK level remained slightly high (315 U/l). Cervical laminoplasty was performed for cervical myelopathy related to cervical DSA (Figure 1).
(a) X-ray of the cervical spine obtained 1 year after the initial surgery revealed progression of the destructive changes, with a C2-7 lordotic angle of -53 . (b) Sagittal T2-weighted MRI of the cervical spine performed one year after the initial surgery showed that the spinal cord was compressed by multisegmental stenosis with kyphotic deformity.
CRIOR2019-7062568.002.jpg
PMC6402219_01_CRIOR2019-7062568.002.jpg
fig2
A marked progression of kyphosis of the subaxial spine was noted with a C2-7 angle of -53  (Figure 2).
X-ray of the cervical spine obtained just after the two-stage additional surgery showed restoration of the cervical alignment by posterior and anterior spinal fusion surgery.
CRIOR2019-7062568.003.jpg
PMC6402219_01_CRIOR2019-7062568.003.jpg
fig3
In the second stage of surgery (10 days after the first stage), anterior spinal fusion was performed from C3 to C7 with an autologous iliac bone graft and a titanium plate (Figure 3).
The time courses of the numerical rating scale score and serum value of creatinine kinase before and after two-stage surgery.
CRIOR2019-7062568.004.jpg
PMC6402219_01_CRIOR2019-7062568.004.jpg
fig4
The serum level of CK was also normalized after the two-stage surgery (Figure 4).