Cervical disc extrusion

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

10 day history of neck pain following a period of exercise in the gym. Sensory deficient along the C8-T1 distribution, and weakeded wrist flexion.

Patient Data

Age: 55 years
Gender: Male

Cervical spine

mri

1.3cm predominantly T1 isointense/T2 hyperintense lesion contiguous with the C6/C7 disc space extruding caudally into the extra-dural space with tenting of the dura. This is causing a moderate-severe amount of displacement of the spinal cord the left within the central canal.  No abnormal enhancement.

No myelomalacia or edema within the cord.

Degenerative change with disc space narrowing at C4/C5 and C5/C6 with moderate disc osteophyte complexes contributing to a mild-moderate degree of central canal stenosis.

Mild bilateral exit foraminal stenosis at C4/C5 and moderate bilateral exit foraminal stenosis at C5/C6.

Case Discussion

Large subacute C6/C7 disc extrusion with cord impingement. This is a far less common site for disc extrusion than the lumbar spine.

The commonest level of occurrence in the cervical spine is at C6/C7.

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