title: Isolated C3-C4 disc herniations present as a painless myelopathy.
abstract: BACKGROUND
  Cervical disc herniations at the C3-C4 level are distinctly uncommon. The authors present the first case series of isolated C3-C4 disc herniations presenting with myelopathy.
  
  
  OBJECTIVE
  To elucidate a rare presentation of the uncommon C3-C4 disc herniation.
  
  
  METHODS
  Case series.
  
  
  METHODS
  The four patients who presented with myelopathy caused by isolated C3-C4 disc herniations, at the spine unit, Vancouver General Hospital between 1999 and 2005.
  
  
  METHODS
  Improvement in neurological status.
  
  
  METHODS
  We retrospectively reviewed the files of the patients. The clinical features and outcome of surgery were assessed.
  
  
  RESULTS
  The C3-C4 disc herniation can present as with no or mild pain, and hand numbness was a prominent symptom. Early recognition and treatment led to favorable outcome.
  
  
  CONCLUSIONS
  Myelopathy is rarely caused by a C3-C4 disc herniation. This etiology may be underdiagnosed but has a more favorable outcome in those cases where rapid diagnosis is followed by spinal cord decompression.
authors: Department of Neurosurgery, Vancouver General Hospital, Vancouver, BC, Canada.
authors: Faisal T
authors: FT
authors: Sayer
authors: Aleksander M
authors: AM
authors: Vitali
authors: Scott
authors: S
authors: Paquette
authors: Christopher R
authors: CR
authors: Honey
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery; D017586:Diskectomy; D005260:Female; D006225:Hand / Q000473:pathology; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery