Upper thoracic disc herniation followed by acutely progressing paraplegia.

Abstract:

STUDY DESIGN:Case report. OBJECTIVE:To report a rare thoracic intervertebral disc herniation followed by acutely progressing paraplegia. SETTING:Spinal Injuries Center, Fukuoka, Japan. METHOD:A 37-year-old man presented with sudden severe backache and acutely progressing motor impairments of both lower extremities after antecedent backache lasting about 5 days. Neurological examination showed analgesia and hypoesthesia below the T4 dermatome level, dysesthesia to pinprick below right inguinal level, and severe motor impairments of the lower extremities (Frankel classification C). Magnetic resonance (MR) imaging demonstrated spinal cord compression due to a postero-laterally existing epidural mass at the T2-T3 level. After laminectomy at the T2-T3 level, the sequestrated disc material was detected and excised as one piece through the right side of the dura. The excised herniated mass had a ring-like form and was thought to originate from the annulus fibrosis. RESULT:After the emergency surgery, he had complete relief from the backache and control of both lower extremities recovered gradually. At 4 weeks after the emergent operation, motor power of both lower extremities recovered almost completely. He was able to walk without any assistance. MR imaging study after surgery did not reveal the sequestrated mass, except for a mild disc bulging at the T2-T3 level. CONCLUSION:Accurate diagnosis of acute symptomatic thoracic disc herniation is occasionally difficult. However, timely and successful surgery could result in complete symptom relief and satisfactory results.

journal_name

Spinal Cord

journal_title

Spinal cord

authors

Sasaki S,Kaji K,Shiba K

doi

10.1038/sj.sc.3101781

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

741-5

issue

12

eissn

1362-4393

issn

1476-5624

pii

3101781

journal_volume

43

pub_type

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