Traumatic cervical disc herniation–tetraparesis in a patient kicked by a horse.

The research discusses a case study of a 51-year-old farmer who suffered a neck disc herniation and tetraparesis after being kicked by a horse. Initial non-invasive treatments showed little success and the condition worsened, necessitating surgical intervention, which showed significant improvement over the following months.

Circumstances and Initial Condition

• The individual, a 51-year-old farmer, was kicked in the forehead by a horse. This led to an immediate onset of tetraparesis that was more pronounced on the right side.
• Physical examination revealed considerable weakness in both his arms and legs, reaching a point where he became incapacitated. Bilateral Babinski signs and heightened deep tendon reflexes were observed.
• He also showed sensory deficits in both of his arms. An MRI indicated a cervical disc herniation at the CIII/CIV level that was causing spinal cord compression and contusion.

Initial Treatments and Their Outcomes

• The patient was first treated with 16 mg of oral dexamethasone per day and a cervical collar.
• Despite slight initial improvements, the patient’s condition deteriorated over time.

Surgical Intervention and Post-Operative Outcomes

• Six weeks after the accident, the farmer underwent an anterior cervical discectomy with interbody fusion, commonly referred to as Cloward’s operation.
• During the procedure, it was observed that the herniated disc material had extruded into the spinal canal through a rupture in the posterior longitudinal ligament, compressing the spinal cord.
• A few days after the surgery, there was noticeable improvement in the strength of the patient’s extremities.
• Two months post-surgery, the patient regained enough strength to walk over short distances.
• Further examination using MRI five months after the operation revealed no remaining disc herniation.
• At a nine-month follow-up post-surgery, the patient’s gait was nearly normalized. However, he reported persistent numbness on his right side.