Cervical disc herniation as a trigger for temporary cervical cord ischemia.

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Cervical disc herniation is a rare cause of acute spinal ischemia.
• Surgical treatment and pre/post-operative diffusion-weighted magnetic resonance imaging (DWI/MRI) analysis for this condition are not well-described.
• This study reports a case of cervical spinal cord ischemia due to cervical disc herniation, discussing diagnostic and treatment options.

Observation:

• A 72-year-old female presented with acute progressive tetraparesis, primarily affecting the upper extremities.
• Cervical MRI revealed a C5/6 disc herniation causing spinal canal stenosis and cervical spinal cord ischemia (C3-C5) on T2-weighted imaging (T2WI) and DWI.
• The findings suggested anterior spinal cord ischemia likely due to anterior spinal artery compression by the herniated disc.

Findings:

• Anterior cervical discectomy and fusion at C5/6 was performed.
• Post-surgery, the patient experienced immediate symptom regression.
• Complete recovery was observed after two months, correlating with normalized cervical cord MRI findings.

Implications:

• The case suggests that cervical disc herniation can cause reversible partial anterior spinal artery syndrome.
• Surgical decompression may effectively treat this rare condition.
• This highlights the importance of considering disc herniation in acute spinal cord ischemia and utilizing advanced MRI techniques for diagnosis and monitoring.