Paraplegia is an impairment in motor or sensory function of the lower extremities.
It is usually caused by spinal cord injury or a congenital condition such as spina bifida that affects the neural elements of the spinal canal. The area of the spinal canal that is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If all four limbs are affected by paralysis, tetraplegia is the proper terminology. If only one limb is affected, the correct term is monoplegia.
Spastic paraplegia is a form of paraplegia defined by spasticity of the affected muscles, rather than flaccid paralysis.
A 38-year-old man visited our Emergency Department for sudden onset paraplegia that occurred 1 hour ago. He felt a piercing pain in the posterior neck and became paraplegic while he was watching television, lying down on a sofa. Neurological examination showed motor power grades II-III in both arms and grade 0 in both legs. His cervical magnetic resonance imaging (MRI) showed a large ruptured disc at the C5-6 level, severely compressing the spinal cord. Emergency anterior cervical discectomy and fusion at C5-6 were performed. Because extensive cord swelling was observed on postoperative MRI, laminoplasty from C3 to C6 was performed 3 days after the initial operation. At a postoperative 8-month follow-up, the motor power was improved to grade III-IV- for both hands and grade IV- for both legs. Nontraumatic cervical disc rupture causing acute paraplegia is a very rare but possible event. Immediate neurologic assessment and thorough imaging studies to allow accurate diagnosis are crucial. Emergency surgical decompression is important and may lead to good neurological outcomes 1).