Images in Clinical Medicine
Post-Traumatic Herniated Cervical Disk
N Engl J Med 2012; 366:462February 2, 2012
- Article
A healthy 18-year-old man had sudden transient tetraplegia after heading a soccer ball. Ten minutes later, he had recovered normal strength. On examination at that time, he had intense cervical pain, paresthesias on his shoulders and arms, and no other neurologic deficits. A sagittal T2-weighted magnetic resonance imaging scan obtained at hospital admission (Panel A) showed bulging C3–C4 disk herniation, with severe spinal cord compression (arrow) and spinal cord edema. T2-weighted sequences did not suggest spinal cord hemorrhage. The C3–C4 disk was almost collapsed. The patient was admitted for urgent surgery. He underwent diskectomy, insertion of an intersomatic polyetheretherketone (PEEK) cage, and placement of a cervical plate (Panel B). He recovered full sensation in his arms and legs and had no neurologic deficits after the surgery. He was able to play soccer 6 months postoperatively.
Sylma Diabira, M.D.
Xavier Morandi, M.D.
Pontchaillou Hospital, Rennes, France
sylma.diabira@chu-rennes. fr
