Isolated C3-C4 disc herniations present as a painless myelopathy.

Abstract

Cervical disc herniations at the C3-C4 level are distinctly uncommon. The authors present the first case series of isolated C3-C4 disc herniations presenting with myelopathy. To elucidate a rare presentation of the uncommon C3-C4 disc herniation. Case series. The four patients who presented with myelopathy caused by isolated C3-C4 disc herniations, at the spine unit, Vancouver General Hospital between 1999 and 2005. Improvement in neurological status. We retrospectively reviewed the files of the patients. The clinical features and outcome of surgery were assessed. The C3-C4 disc herniation can present as with no or mild pain, and hand numbness was a prominent symptom. Early recognition and treatment led to favorable outcome. Myelopathy is rarely caused by a C3-C4 disc herniation. This etiology may be underdiagnosed but has a more favorable outcome in those cases where rapid diagnosis is followed by spinal cord decompression.