Non-traumatic acute paraplegia associated with cervical disc herniation: a case report.
BACKGROUND
Acute paraplegia attributable to disc herniation is known to occur most frequently at the thoracic level. We report a rare case of non-traumatic acute paraplegia caused by disc herniation at the cervical level. Preoperative magnetic resonance imaging (MRI) of the present case demonstrated a spinal cord lesion as a cause of paraplegia. Although this symptom is believed to disappear rapidly after surgical treatment, there have been a few reported cases with poor neurologic recovery and permanent deficits.


METHODS
A 61-year-old female with a history of minor neck pain suffered from non-traumatic acute paraplegia attributable to cervical disc herniation. She underwent emergency surgery consisting of vertebrectomy, removal of herniated discs, and anterior fusion. Postoperative neurologic improvement was slow due to the cervical spinal cord lesion at the central portion of the cord, which was detected by the preoperative and postoperative MRIs.


CONCLUSIONS
We emphasize that the MRI study is crucial for the management of patients with acute neck pain associated with cervical canal stenosis. Surgical treatment should not be delayed to avoid permanent neurologic deficits. Anterior decompression with vertebrectomy is recommended to decompress the injured spinal cord in the narrow cervical spinal canal; however, a cord lesion detected by MRI may indicate an incomplete surgical outcome.
Ueyama
T
T
Department of Neurosurgery, Kobe University School of Medicine, Japan.
Tamaki
N
N
Kondoh
T
T
Miyamoto
H
H
Akiyama
H
H
Nagashima
T
T
D000208:Acute Disease; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology* / Q000473:pathology