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2016, Volume 7, Number 3, Page(s) 218-226
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Acute Two-Level Cervical Soft Disc Herniation with Radiculopathy: Case Report and Review of the Literature
Rahimizadeh Abolfazl, Hassani Valiolah, Hajimirzabeigi Alireza, Rahimizadeh Ava
Departments of Spinal Surgery and Anesthesiology & Pain, Pars Advanced and Minimally Invasive Research Center, Pars Hospital, Affiliated to Iran University of Medical Sciences, Tehran, Iran
Keywords: Acute cervical disc herniation, anterior cervical disc fusion cervical disc arthroplasty, foraminal block, natural history, outcome, spontaneous resolution, two-level cervical disc herniation
Abstract
Acute two-level cervical soft disc herniation in a subject without underlying degenerative changes is rare. Only 3 cases could be found with a careful review of the literature. All such herniations are located in the midline, presenting with either quadriparesis or Brown-Sequard syndrome. However, laterally located two-level acute cervical sequestrated disc herniation with only radiculopathy seems to be extremely rare and not a single case could be found in our review.

Herein, we present a young male who developed severe upper limb radiculopathy not responsive to medication. MRI revealed two large cervical sequestrated discs located posterolaterally at the C5-C6 and C6-C7 levels. With consideration of the severity of pain not responsive to medications, two-level arthroplasty was advocated, but the patient refused despite pain intensity. Therefore, periradicular cervical block was done at 2 levels, which caused dramatic pain relief thereafter. Conservative treatment was continued with NSAIDs and analgesics. A week after the block, he restarted most of his previous activities. Three months later, follow-up MRI revealed complete resolution of the corresponding sequestrated discs.

To our knowledge, acute two-level cervical disc herniation with brachialgia is extremely rare with no similar case being found in the literature.

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