Neurological impairment in a patient with concurrent cervical disc herniation and POEMS syndrome

Eur Spine J. 2019 Jun;28(Suppl 2):51-55. doi: 10.1007/s00586-019-05914-5. Epub 2019 Feb 13.

Abstract

Purpose: POEMS syndrome is a rare clonal plasma cell disease characterized by polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. We report a rare case of neurological impairment in patients with concurrent cervical disc herniation and POEMS syndrome.

Methods: A patient presented to a local hospital with C3/4 and C4/5 disc herniation, apparent spinal cord compression concomitant with neurological signs, and concurrent POEMS syndrome. Anterior cervical discectomy and fusion was performed.

Results: The limb numbness was only slightly alleviated, and 10 days postoperatively the patient complained of muscle weakness of the extremities and was referred to our hospital. The patients exhibited non-typical neurological signs and an enlarged liver and spleen that could not be explained. Electroneuromyography and immunofixation electrophoresis produced abnormal results. We diagnosed concurrent POEMS syndrome, for which drug therapy was prescribed. The patient's symptoms receded.

Conclusion: Patients presenting with cervical spondylopathy and non-typical neurological signs and symptoms or other systemic problems should be evaluated for the presence of concurrent disease and ruled out differential diagnoses.

Keywords: Cervical disc herniation; Cervical spondylosis; Neurological impairment; POMES syndrome.

Publication types

  • Review

MeSH terms

  • Cervical Vertebrae / surgery
  • Diagnosis, Differential
  • Diskectomy
  • Humans
  • Intervertebral Disc Degeneration* / complications
  • Intervertebral Disc Degeneration* / surgery
  • Intervertebral Disc Displacement* / complications
  • Intervertebral Disc Displacement* / surgery
  • Muscle Weakness / etiology*
  • POEMS Syndrome* / complications
  • POEMS Syndrome* / diagnosis
  • Spinal Fusion

Supplementary concepts

  • Intervertebral disc disease