急性腰椎间盘突出症并发马尾神经损伤一例报告

1病历摘要 男性患者,34岁,因腰痛伴双下肢麻木、疼痛2个月,大小便功能障碍1d于2010年1月8日入院。患者2个月前因劳累后出现腰痛及双下肢麻木、疼痛来我院门诊就诊,初诊为腰椎间盘突出症。给予脱水消肿、活血止痛、理疗等对症治疗,     

Adolescent lumbar disc herniation: a case report

Lumbar spine disc herniations in children are a relatively rare condition reported to occur in less than 3% of those presenting with low back pain. Unlike the adult, the etiology and clinical picture often provides few clues to making the diagnosis. Although conservative management is the treatment of choice, surgical intervention may be required in some cases. The role of spinal manipulation in these cases may be of limited value. A case report is presented that illustrates the difficulty in making the diagnosis and conservatively managing lumbar disc herniations in children.     

经皮穿刺腰椎间盘切吸术治疗合并腰椎管狭窄的腰椎间盘突出症

目的：总结采用经皮穿刺腰椎间盘切吸术（APLD）治疗合并腰椎管狭窄的腰椎间盘突出症的经验。方法：对12例经CT扫描确诊为腰椎间盘突出症合并有腰椎管狭窄患者，术前行轴位牵引下直腿抬高试验检查。对属可逆性腰椎间突出患者，使用APLD治疗。结果：经3个月以上随访，优7例，良4例，可1例。近期优良率91．7％，未出现并发症。结论：合并腰椎管狭窄的腰椎间盘突出症不应列为APLD治疗的禁忌证。对术前行轴位牵引下直腿抬高试验检查属可逆性腰椎间盘突出的患者，仍可行APLD治疗。     

Osteopoikilosis mimicking lumbar disc herniation: a case report

It is important for the chiropractor to be able to determine the nature of the pathology discovered on plain film radiography, and to suggest appropriate follow-up investigations, deemed to be clinically appropriate. This case demonstrates the value of plain-film radiography in diagnosing a rare sclerosing bone dysplasia, which in 10–15% of affected individuals is associated with articular pain and swelling. However, the demonstration of the lesions on CT is unusual, in so far as plain-film radiography is the gold standard by which to diagnose this condition.     

Atypical lumbar disc herniation: a case report.

BACKGROUND CONTEXT: This is a case report of a right posterolateral L5-S1 disc herniation that migrated to the left cephalad level to impinge on the left L5 nerve root as it exited the dura. The resultant free fragment migration is a rare variation of a posterolateral disc disruption. PURPOSE: The purpose is to report a rare variation of lumbar disc herniation not previously reported in the literature. STUDY DESIGN/SETTING: Case report. PATIENT SAMPLE: A 60-year-old white woman. OUTCOME MEASURES: Resolution of the patient's left lower extremity symptoms.METHODS: Not applicable. RESULTS: The patient experienced resolution of most of her left lower extremity symptoms after a slightly modified microscopically assisted lumbar hemilaminectomy, discectomy and nerve root decompression. CONCLUSIONS: This is a rare right to left migration of a sequestrated disc herniation, which was effectively treated with surgery.     

Intraradicular herniation of a lumbar disc: a case report

The authors report an unusual case of intraradicular lumbar disc herniation. A large fragment of lumbar disc was found within the sheath of the right S1 nerve root. Surgical treatment results in a satisfactory clinical outcome. The literature on intradural and intraradicular lumbar disc herniation is reviewed.     

Lateral lumbar disk herniation]

The authors present the clinical evaluation of 41 patients with extreme lateral disc herniation in the lumbar spine. This group of patients represented 3.1% of all patients operated to to discopathy of the lumbar spine at the Department of Neurosurgery of the Medical Academy of Bia?ystock in the years 1988-1997. Males constituted 95.1% of the study series, with an age range 41-60 years. In 92.7% of the patients extreme lateral herniation was diagnosed either at L4-L5 level or L5-S1 level. In 78.1% of the cases different types of motoric disturbances were observed, while in 65.8% radicular type disorders in superficial sensibility were noted.     

不典型老年极外侧腰椎间盘突出症合并椎管狭窄症脊柱内镜翻修1例

<正>女性患者,74岁,因“腰部间断疼痛、间歇性跛行1年,加重伴右下肢疼痛1个月”,于2020年8月24日在当地医院骨科住院,主要症状为腰痛伴右小腿前外侧疼痛,2020年8月29日,当地医院按“腰椎椎管狭窄症”“腰椎间盘突出症”诊断在局部麻醉下行经皮椎间孔脊柱内镜手术,术后患者腰痛及右小腿前外侧疼痛明显缓解,但右小腿胫前侧出现剧烈疼痛并进行性加重,严重影响患者睡眠,     

Nerve root herniation secondary to lumbar puncture in the patient with lumbar canal stenosis. A case report.

STUDY DESIGN: A very rare case of nerve root herniation secondary to lumbar puncture is reported. OBJECTIVE: To describe the characteristic clinical features of this case and to discuss a mechanism of the nerve root herniation. SUMMARY OF BACKGROUND DATA: There has been no previous report of nerve root herniation secondary to lumbar puncture. METHODS: A 66-year-old woman who experienced intermittent claudication as a result of sciatic pain on her right side was evaluated by radiography and magnetic resonance imaging, the results of which demonstrated central-type canal stenosis at L4-L5. The right sciatic pain was exacerbated after lumbar puncture. Myelography and subsequent computed tomography showed marked stenosis of the thecal sac that was eccentric to the left, unlike the previous magnetic resonance imaging finding. RESULTS: At surgery, a herniated nerve root was found through a small rent of the dorsocentral portion of the thecal sac at L4-L5, presenting a loop with epineural bleeding. The herniated nerve root was put back into the intrathecal space, and the dural tear was repaired. CONCLUSION: Lumbar puncture can be a cause of nerve root herniation in cases of lumbar canal stenosis. The puncture should not be carried out at an area of stenosis.     

Postoperative intraradicular lumbar disc herniation: A case report

An unusual case is presented in which a fragment of herniated lumbar disc was found within the sheath of the right S-1 nerve root. Diagnosis of intradural and intraradicular lumbar disc herniation is difficult, so that it is rarely suspected preoperatively. Surgical treatment results in a satisfactory clinical outcome.     

Thoracic disk herniation with hematoma--case report

A 54-year-old man presented with an extremely rare case of intervertebral disk herniation with hematoma in the thoracic spine, manifesting as acute progressive numbness and muscle weakness in the bilateral lower extremities. He had been treated with anticoagulants. Magnetic resonance imaging of the thoracic spine showed intervertebral disk herniation and severe compression of the spinal cord at T9-10, appearing as hyperintense on T(1)- and hypointense on T(2)-weighted imaging suggestive of concomitant hematoma. His symptoms completely resolved after resection of the brownish herniated disk material. Old hemorrhage was also aspirated from the intervertebral disk space. Hemosiderin deposition was found in the cartilaginous tissue of the resected disk. Intervertebral disk herniation with hematoma is extremely rare, but may occur in patients with bleeding diathesis.     

Spinal nerve root herniation into a pseudomeningocele associated with lumbar spondylolysis: a case report

A 38-year-old man presented with low back pain and sciatica on the left side. Magnetic resonance imaging showed spinal nerve root herniation into a pseudomeningocele associated with lumbar spondylolysis. After closure of the dural defect, the sciatic pain was relieved and subsequently the patient was able to return to work.     

Adolescent apophyseal ring fracture simulating lumbar disc herniation: a case report

Lumbar disc herniation in adolescents is a rare condition. It is commonly associated with fracture of the vertebral ring apophysis. The diagnosis is most clearly established by CT scan. The differential diagnosis is important and should include spine and spinal cord tumours, discitis and neuropathy. A case is presented to illustrate the pathophysiology, clinical and radiological diagnosis and to discuss the differential diagnosis.     

Epidemiological factors of lumbar disk herniation

Two series of patients operated on for an herniated lumbar disc are studied retrospectively for the 484 cases of the first one and prospectively for the 289 cases of the second series. In both series, the large majority of the cases are aged between 30 and 60 years, about 60% are males and the body mass index (B.M.I.) is equally distributed among the patients and in the general swiss population of the same age. Only young men are heavier than the average. All the professions are represented among the patients, as the inactives or housewives, and not very different than in the normal population. Only in the first series heavy workers are considered as more frequent among the patients than in the population of Geneva. This is not confirmed by the second series. Sport is a possible factor implicated in the disease. It is suggested that heavy work or intensive sport in the adolescence can influence this problem. The incidence of herniated disc syndrome calculated from the second series in Geneva for people aged 20 to 69 is 62 cases/100,000/y, 75 for male and 51 for female. This is under the reality because some cases are operated in private clinics.     

Trends in adolescent lumbar disk herniation

The authors have retrospectively studied the trends in etiology, symptoms, and rate of recurrence for adolescents with disk herniations to determine the age at onset of symptoms, mechanism of injury, familial history, pattern of symptoms, level of herniation, method of treatment, and rate of recurrence. The review revealed a higher incidence of adolescent lumbar disk herniations in female patients and a higher percentage of patients with a family history than previously reported. Leg pain continues to be the primary presenting symptom in this group of patients and is often not recognized as the radicular pain of a herniated disk by the primary care physician. This reflects a lack of understanding of the relationship of the presenting symptoms to the pathology of the herniated nucleus pulposus, causing a delay in referral to the spine specialist.     

Malignant schwannoma: report of a case mimicking lumbar disk disease.

Primary neurogenic retroperitoneal tumors in the adult are rare. This case presentation reviews an unusual history of a patient who presented with pain and neurologic deficits suggesting lumbar disk disease but who was unrelieved by laminectomy and disk removal. Later he was found to have a malignant schwannoma arising from the right L nerve root. Experience such as this reminds physicians that when the result of treatment is not as expected the original diagnosis must be questioned.