T2-3 Thoracic disc herniation with myelopathy

We report a case of thoracic disc herniation in a 53-year-old woman who presented to the Emergency Department (ED) with a 2-week history of acute lower back numbness and intermittent fecal incontinence. On examination, she had lower extremity hyperreflexia, an abnormal gait, and lower lumbar pain but lacked any radicular findings. A magnetic resonance imaging scan revealed a large focal paracentral herniated disc at the T2-3 level. The patient underwent successful T2-3 anterior discectomy with T2-3 rib autograft fusion. Nine months after surgery her weakness and gait had improved, but she continued to have recurrent intermittent fecal incontinence. Thoracic disc herniation is an uncommon, but treatable cause of spinal cord compression. Prompt recognition and early treatment are the keys to preventing permanent neurologic sequelae.