Nontraumatic acute complete paraplegia resulting from cervical disc herniation: a case report.
METHODS
A case report of nontraumatic acute complete paraplegia resulting from cervical disc herniation.


OBJECTIVE
To describe a rare case of nontraumatic paraplegia resulting from enlargement of a herniated disc in the cervical spine and to outline appropriate management of a patient with severe spinal cord compression secondary to disc herniation with developmental spinal canal stenosis.


BACKGROUND
Acute progression of myelopathy into complete paraplegia resulting from disc herniation is rare. There are only four reported cases of nontraumatic acute myelopathy secondary to cervical disc herniation. No other report has described magnetic resonance imaging findings noted before and after the onset of acute myelopathy.


METHODS
A cervical disc herniation at C6-C7 is reported in a 29-year-old man who had nontraumatic acute complete paraplegia. Neurologic and magnetic resonance imaging findings are evaluated and discussed.


RESULTS
Disc herniation at C6-C7 enlarged nontraumatically, resulting in complete paraplegia. Emergent anterior decompression followed by secondary posterior multilevel decompression was performed. Magnetic resonance imaging studies revealed localized high signal intensity change in the spinal cord. No neurologic recovery was achieved 3 years post-surgery.


CONCLUSIONS
We emphasize that there is a possibility of acute, irreversible progression of paralysis secondary to nontraumatic enlargement of cervical disc herniation with canal stenosis. In these cases, immediate early decompressive surgery is crucial to the prevention of severe myelopathy.
Suzuki
Tetsuya
T
Department of Orthopedic Surgery, Akita University School of Medicine, Akita, Japan. tetsuya@doc.med.akita-u.ac.jp
Abe
Eiji
E
Murai
Hajime
H
Kobayashi
Takashi
T
D000208:Acute Disease; D000328:Adult; D019299:Decompression, Surgical; D018450:Disease Progression; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009333:Neck; D010264:Paraplegia / Q000209:etiology*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology