Clinical Scorecard: Case Report: Multilevel Cervical Disc Herniation with Myeloradiculopathy in a Patient with Clinically Probable Alkaptonuria-Related Ochronosis Treated by Anterior Cervical Discectomy and Fusion at C4–7

At a Glance

Key Highlights

• Rare case of cervical disc herniation due to alkaptonuria
• Intraoperative finding of black-pigmented intervertebral discs
• Patient experienced early postoperative improvement in symptoms

Guideline-Based Recommendations

Diagnosis

• Consider alkaptonuria in patients with black intervertebral discs during cervical discectomy
• Document and sample tissue for microbiological testing

Management

• Perform anterior cervical discectomy and fusion for multilevel cervical compression
• Ensure segmental stabilization post-decompression

Monitoring & Follow-up

• Conduct quantitative urinary homogentisic acid measurement
• Consider HGD genetic testing when available

Risks

• Potential for misdiagnosis if systemic context of alkaptonuria is not recognized
• Neurological compromise due to cervical disc herniation

Patient & Prescribing Data

Adults with a history of hypertension and progressive cervical symptoms

Clinical Best Practices

• Recognize the significance of black discs during cervical surgery
• Promptly consider underlying metabolic disorders in surgical evaluations

Related Resources & Content

• Case Report Reference