Atraumatic Cervical Disc Herniation With Rapidly Progressive Myelopathy in a 47-Year-Old Male: A Case Report.

Atraumatic acute myelopathy caused by idiopathic disc herniation is rare. This case presents a 47-year-old male with a sudden onset of severe neck pain and weakness upon waking that progressively worsened. His rapidly progressive myelopathy led to an MRI of the cervical spine, revealing severe spinal canal stenosis at the C6-C7 level due to a large disc herniation deforming the spinal cord. The patient underwent anterior cervical discectomy and fusion (ACDF) at the C6-C7 level. Postoperatively, he showed significant improvement in pain and paresthesia, though some residual numbness and balance issues persisted. This case highlights the rapid progression and severe neurological impact of cervical spinal stenosis due to disc herniation. Despite reassuring findings on initial CT imaging, the patient's rapidly worsening symptoms on reassessment prompted an MRI, which confirmed the diagnosis and highlighted the urgent need for surgical intervention. The successful outcome for this patient is largely due to the rapid identification and surgical decompression of his severe cervical spinal cord compression. Cervical spinal stenosis, particularly when associated with disc herniation, can lead to profound, irreversible neurological impairment if not promptly addressed. This case demonstrates the critical need for early clinician identification and surgical intervention to prevent permanent deficits and improve patient outcomes.