Open AccessNontraumatic Acute Anterior Cord Syndrome Caused by Cervical Disc Herniation after Napping with Neck Extension
Author(s) -
Chen YL,
Wu YT,
Hsia CC,
Chang ST,
Chiang SL
Publication year - 2013
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490791302000611
Subject(s) - medicine , surgery , cord , magnetic resonance imaging , spinal cord , neck pain , sensory loss , spinal cord injury , anterior longitudinal ligament , anterior cervical discectomy and fusion , anesthesia , cervical spine , radiology , alternative medicine , pathology , psychiatry
Nontraumatic acute anterior cord syndrome caused by disc herniation occurring in the cervical spine is rare. A 39‐year‐old man presented with a sharp burning pain in bilateral upper limbs and progressive paraplegia after a nap with neck extension. He had impaired sensation of pain and temperature with preservation of proprioception and light touch below the C6 level. The magnetic resonance imaging showed focal hyperintensity of the anterior cord at the C5‐C7 level and central herniation of C5‐6 and C6‐7 discs. An anterior discectomy of C5‐6 and C6‐7 was conducted because of the poor response to a high dose of steroid. A postoperative intensive rehabilitation treatment was also performed. The patient showed significant improvement in motor and sensory function three months postoperatively. Long‐term repetitive neck extension should be avoided because it may be a risk for degenerative spondylotic change and cord compression disorders. Surgical intervention should be considered in a patient with anterior cord syndrome associated with nontraumatic cervical disc herniation. (Hong Kong j.emerg.med. 2013;20:389‐391)