Acute cervical intervertebral disc herniation after traffic accident: the importance of rapid diagnosis with magnetic resonance imaging in the emergency department

The cervical vertebrae (C1-C7) are the most commonly injured region of the spine because they are the most flexible, mobile, and exposed part of the spinal column. Different studies have demonstrated that cervical spine injuries are more common in motor vehicle accidents. An acute intervertebral disc herniation may develop due to hyperextension of the cervical region in trauma-related conditions such as motor vehicle accidents. Rapid and definitive diagnosis is possible with magnetic resonance imaging (MRI). In acute cervical spine injury, MRI is the gold standard for the surgeon to decide on issues such as the need for surgery, the type of approach, the need for instrumentation, the level of decompression, and the need for re-surgery in case of insufficient decompression, as well as the presence of edema or hematoma. In this case report, a patient with plegia is presented who had an acute intervertebral disc herniation without cervical spine fracture due to hyperextension of the cervical region during a motor vehicle accident and whose diagnosis was possible with early consultation and MRI. Computed tomography and X-ray imaging were normal. The patient’s clinical status could not have been adequately elucidated without the performance of MRI. As a matter of fact, according to the spinal cord trauma guidelines, neurological recovery is faster and more favorable in cases operated on within 24 hours, as observed in our case. This article was written to emphasize that relying solely on Computed tomography or X-ray may be insufficient, and that MRI should not be avoided when clinically indicated. To identify and monitor the presence and underlying causes of spinal cord hematoma, edema, and stenosis, MRI is required.