Spontaneous regression of a traumatic cervical prolapsed intervertebral disc with myelopathy

Abstract

We report the case of a 60-year-old male, who presented to us with a 6-month-old quadriparesis (upper limbs 3/5; lower limbs 0/5), secondary to a posttraumatic C5-C6/C6-C7 prolapsed intervertebral disc (PIVD), and a D4-D5 fracture-dislocation, resulting in a physiological dorsal cord transection. The patient had been managed conservatively outside. In view of the insignificant neurological recovery over the past 6 months, the patient consulted for a second opinion. At the time, the patient also had an infected decubitus ulcer. Due to the significant thecal compression at the C5-C6 level, and the partial improvement in upper limbs power, we suspected a possible ongoing dynamic cord injury. The patient was planned for an anterior cervical discectomy and fusion at the C5-C6 level once the decubitus ulcer was managed. After a month, with the patient's pressure sore healed, a repeat magnetic resonance imaging cervico-dorsal spine showed a near-complete spontaneous regression of the C5-C6 PIVD.