Abstract
Enlarged thyroid gland (goiter) may hinder to reach anterior part of the vertebrae or may impose more retraction than usual. The patient had left arm pain, and his left biceps muscle strength was 3/5 and triceps muscle strength was 4/5. Physical examination of his neck showed no abnormality. We performed anterior cervical discectomy, but we did not reach to the anterior part of the vertebrae due to enlarged thyroid gland even making moderately forceful medial retraction. It is therefore, we performed thyroidectomy previously, and later we performed anterior cervical discectomy at the level of cervical 5-6 and cervical 6-7. It will be wise to excise the goiter and later continue to cervical discectomy rather than using forceful retraction in cases with no preoperative detection as in our case to prevent damage of the recurrent laryngeal nerve and hoarseness due to pressure effect of the medial retraction during the anterior cervical approach.
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.