Nontraumatic acute myelopathy associated with cervical disc herniation during labor

Abstract

Nontraumatic acute myelopathy caused by cervical disc herniation is rare, and no case has been reported which the disease progresses during active labor. A 32-year-old primiparous woman encountered left cervical myelopathy during the second stage of labor. Cesarean section was performed two hours later because of the arrest of descent. Magnetic resonance imaging revealed C3–C6 disc herniation with a focal hyperintense signal in the cervical cord at C3–C4 level. She underwent anterior multilevel diskectomy with fusion and rehabilitation. She walked independently 1 month after surgery and reported only minimal paraesthesia in hands by 18 months. Our case suggested that accurate diagnosis, early surgical intervention, and pertinent rehabilitation would be the keys to successful management.