Figure 2.

A 58-year-old female, complaint of walking clumsy and radiation pain for both upper extremities for more than 2 years, JOA score was 6 pre-surgery, underwent ACDF after distinguishing from neurological diseases, and so on, and the failure of 3 months’ conservative treatment. Half year after surgery, the JOA score significantly increased from 6 to 15. Preoperative x-ray: (A) A-P view; (B) neutral lateral view; (C) extension lateral view; (D) flexion lateral view. Preoperative MRI: (E) Sagittal MRI indicated disc degeneration and herniation of C4/5 and C5/6; (F) Coronary MRI at C4/5 indicated CSA was 83.3 mm² and inner distance of longus colli was 12.6 mm. 1 year's postoperative x-ray: (G) A-P view; (H) lateral view. ACDF = anterior cervical discectomy and fusion, CSA = cross-sectional area, JOA = Japanese Orthopaedic Association, MRI = magnetic resonance imaging.