Successful outcomes following transforaminal epidural steroid injections for C4/5 cervical disc prolapse associated with profound neurological deficit.

PURPOSE: To show that with C5 radiculopathy and profound neurological deficit, good outcomes can be obtained with injection therapy. METHOD: We present two cases of cervical radiculopathy secondary to disc prolapse associated with profound neurological deficit. In both cases, cervical injection therapy was used as the primary management. RESULTS: The two cases presented were both male, 59 and 36 years, and were diagnosed on MRI imaging with C4/5 disc prolapses. They presented with severe motor deficit and were both treated with foraminal epidural steroid injections, one of the patients also had two previous injections elsewhere prior to the first review. In both patients, pain and neurological deficit improved in a timely manner resulting in full recovery. MRI taken after recovery showed complete resorption of the disc prolapse in both cases. CONCLUSION: In C5 radiculopathy, even with severe neurological deficit, cervical injection therapy should be considered. These cases illustrate that excellent results can be obtained without the need for open surgery with its inherent risks.