Two-Level Anterior Cervical Decompression with Disc Replacement for Cervical Myelopathy: A Technical Note

Abstract

Background: Anterior cervical decompression for multilevel disease, particularly when spinal cord compression extends posterior to the vertebral body, is traditionally performed via corpectomy. However, corpectomy carries risks of graft subsidence, nonunion, and loss of motion. Cervical disc arthroplasty has emerged as a motion-preserving alternative.Case Description:We present a 45-year-old female with cervical myelopathy caused by contiguous disc herniations and cord compression.Technical Note:A two-level anterior cervical decompression with disc replacement was performed at C6–C7 and C7–T1. A migrated soft disc fragment posterior to the vertebral body was removed through a discectomy corridor with angled instrumentation. Disc prostheses were implanted at both levels to preserve motion.Conclusion:Two-level anterior decompression with disc arthroplasty can be a safe and effective alternative to corpectomy in carefully selected patients, even when compression extends behind the vertebral body.

Keywords: Cervical myelopathy; Disc replacement; Corpectomy; Motion preservation; Anterior decompression