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Case Reports
. 2010;33(4):420-4.
doi: 10.1080/10790268.2010.11689721.

Nontraumatic acute paraplegia associated with cervical disk herniation

Chao Liu  1 , Yue Huang, Hong-Xin Cai, Shun-Wu Fan
Affiliations
Case Reports

Nontraumatic acute paraplegia associated with cervical disk herniation

Chao Liu et al. J Spinal Cord Med. 2010.

Abstract

Background: Acute paraplegia is a true emergency. It is often the result of trauma but is rarely reported in association with cervical disk herniation in patients without antecedent injury.

Methods: Case report.

Findings: This 75-year-old man presented with acute paraplegia due to severe compression of the spinal cord by herniation of the C4-C5 cervical disk. He underwent emergency diskectomy and anterior fusion. Postoperatively, his neurologic functions improved gradually.

Conclusions: Cervical disk herniation should be considered in the differential diagnosis of nontraumatic acute paraplegia. Pre-existing narrowed canal is an important predisposing factor and excessive neck movements are believed to be triggering factors. Immediate early decompressive surgery is recommended to avoid irreversible progression of neurologic deficit.

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Figures

Figure 1
Figure 1
A lateral radiograph showed osteophytes at multiple levels, loss of lordotic curve, and slight spondyloptosis at C5 vertebra.
Figure 2
Figure 2
Sagittal T2-weighted magnetic resonance imaging revealed a sizable herniated mass at C4-C5 with high-intensity signal and mild herniation and degeneration at C3-C4 and C5-C6.
Figure 3
Figure 3
Axial T1-weighted magnetic resonance of the C3-C4, C4, C4-C5, and C5-C6 levels. At C4-C5, a heterogeneous mass occupied the spinal canal anterolaterally, causing the spinal cord compression.
Figure 4
Figure 4
(A) The excised sequestrated disk was rectangular and measured 1.3 × 1.0 × 0.2 cm. (B) Photomicrograph of this tissue specimen (stained with hematoxylin-eosin), showing fiber alignment irregularity accompanied by vascularized granulation tissue.
See this image and copyright information in PMC

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