I've been seeing the Docs at Mayo Clinic to see if they could do what all the other docs couldn't: Figure out what's wrong with my hands and arms. Since my strength was down about 80% in my right hand I was quickly referred to a diagnostic team of Drs. Hammack and Pickleman. They pretty quickly came up with the diagnosis of a compressed nerve in my neck and the need to fuse C7 and T1. Dr Pickleman operated on me Thursday.

DESCRIPTION OF PROCEDURE The patient was brought to the operating room and placed under general endotracheal anesthesia. He was positioned supine on the operating room table. All pressure points were padded, and he was secured. The neck was then prepped and draped in the usual sterile fashion. Following confirmatory pause, a right transverse incision was made just above the clavicle. The platysma was divided and dissection was carried down between the tracheoesophageal complex and the carotid sheath into the prevertebral space. Dissection was difficult due to prior surgery and radiation to the area. This should include a difficulty level in addition to the usual procedure. Once prevertebral space was opened, intraoperative fluoroscopy confirmed our levels. Longus colli muscles were elevated and retracted to expose the C7-T1 disk space. Operating microscope was then brought into the field, and the remainder of the case was done using microsurgical techniques with the operating microscope. We began by performing a thorough diskectomy at C7-T1 using a combination of curettes and disk punches. A high-speed bur was then used to remove the posterior osteophytes at the level, as well as perform an uncinectomy on the right, thereby decompressing the right C8 nerve root. Satisfied with the decompression, the endplates were prepared and trial spacers were introduced. A 5 x 7 VG2 allograft spacer was then gently tapped into the interspace. Caspar pins, which were previously placed for distraction, were removed. A 16-mm Skyline plate was then positioned at the C7-T1 interspace. Pilot holes were drilled and 16-mm constrained screws were placed bilaterally at C7 and T1, and the locking mechanism was advanced. Intraoperative fluoroscopy confirmed good positioning of the implant. A 10-French round Jackson-Pratt drain was exited through a separate stab incision, and the wound was closed in anatomic layers.