Few symptomatic anterior cervical disc herniations have been found in the literatures. We describe a rare case of an anterior cervical disc herniation presenting as instability and minimal dysphagia. A 62-year-old man presented with a 3-months history of axial neck pain and minimal dysphagia that did not respond to a conservative treatment. Preoperative plain X-rays of the cervical spine revealed loss of normal lordotic curvature with no definite narrowing of the disc spaces. Flexion/extension radiographs of the cervical spine revealed segmental instability as angular motion greater than 11 degree between adjacent segment at C5-6. Cervical magnetic resonance (MR) imaging revealed a 1.7 x 0.8 cm extruded disc in the left anterior aspect of the C5-6 disc space on axial T2-weighted images and an anteriorly extruded disc with the base at the C5-6 disc, which displaced the esophagus anteriorly on sagittal T2-weighted images. The patient underwent on a cervical disc removal, followed by stabilization of the C5 and C6 via the anterior approach. Preoperative complaints were resolved completely after the surgery. He remained symptom-free 9 months after the surgery.
