• Hiroyoshi Akutsu, Kiyoyuki Yanaka, Noriaki Sakamoto, Akira Matsumura, and Tadao Nose.
• Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
• J Clin Neurosci. 2004 Nov 1;11(8):932-4.

AbstractA 69-year-old man was admitted to our hospital with progressive numbness in both feet and gait disturbance. MR imaging revealed a large cervical disc herniation resulting in significant spinal cord compression with hyperintensity of the spinal cord on T2-weighted images at C-5/6. Immediately after undergoing anterior cervical discectomy, the patient developed severe weakness of his left hand and lower extremities. MR imaging obtained 5 days after surgery revealed a long segment hyperintensity between C-3 and T-2 on T2-weighted images. This long segment hyperintensity disappeared after 2 weeks of steroid administration. We suspect that the persistent, localised, patchy C-5/6 cord hyperintensity represents spinal cord degeneration due to ischaemia and trauma resulting from the disc herniation. However, the transient long segment hyperintensity may represent oedema, probably due to minor trauma of an already compromised cord, during the decompression surgery. Clinicians should be aware that even careful surgery can result in a significant change in radiological studies and neurological condition.

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