Futoshi Suetsuna, Yoshihiko Okudera, Toshihiro Tanaka and Takuya Tamura
The authors report the case of a 24-year-old man who presented with sudden onset quadriplegia while doing a bench press in the supine position. He had a history of cervical disc herniation at the C6/7 level. Plain x-rays showed no spinal fracture and no spinal canal stenosis. MRI revealed a C6/7 disc herniation that severely compressed the spinal cord. Physical exam showed complete spinal cord injury below C8 level. Urgent C6/7 anterior decompression and fusion using hydroxyapatite (HA) was performed. A large, sequestrated herniation mass into the spinal canal was removed. His neurological deficits improved gradually after surgery. Over 3 years postoperatively, he can walk by himself without crutches, though he has slight motor weakness of left finger and foot, paresthesia below C8 on the right, and slight bladder disturbance.
Many cases of cervical spinal cord injury caused by sporting injury have been reported. Those cases generally accompanied high energy trauma such as fracture dislocations. This case did not involve any large cervical motion before injury or any spinal fracture. This very important case shows the possibility of a spinal cord injury in supine position without high energy trauma. Patients with cervical disc herniation should be counseled about the risk of participating in sports, including those without significant neck motion.
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