Technical note: unilateral posterior resection of cervical disc and spondylostenosis with contralateral fusion for instability.

Background: Posterior cervical unilateral diskectomy and decompression for stenosis with instability may be successfully stabilized with contralateral diskectomy and fusion.

Methods: A 49-year-old male with a left-sided C8 radiculopathy had dynamic X-ray, MR, and CT studies that documented an old anterior diskectomy and fusion at the C5-C6 level, and a new left-sided foraminal disc herniation at the C7-T1 level with instability, accompanied by C6-T1 spondylostenosis. Following left-sided C6-T1 laminectomies with excision of C7-T1 disc, a contralateral right-sided C5-T2 fusion was performed with fibula strut allograft wired to the spinous processes using titanium cable and iliac crest autograft.

Results: X-ray and 2D CT studies performed 3 and 6 months postoperatively confirmed adequate unilateral decompression of stenosis with disc removal and contralateral fusion. Within three weeks of surgery, the patient had no residual neurological deficit. Three years later, he remained intact, and X-ray studies continued to demonstrate spinal stability.

Conclusions: A unilateral C7-T1 disc herniation with instability accompanied by C6-T1 spondylostenosis were successfully managed with unilateral decompression and disc excision followed by contralateral fusion.