Published online Sep 30, 2008.
https://doi.org/10.4184/jkss.2008.15.3.190
Paraparesis due to Posterior Migration of Ruptured Disc in the Adjacent Segment after Spinal Fusion - Unusual Junctional Problem -
Abstract
Posterior epidural migration of sequestered lumbar disc fragments is an uncommon event. We present here an especially uncommon case involving a patient with paraparesis that was due to posterior migration of a ruptured disc in the adjacent segment after spinal fusion. The patient had a herniated lumbar disc in a diseased spinal junction with sequestered fragments that were located posterior to the thecal sac.
Fig. 1
(A) Initial x-ray of the thoraco-lumbar spine shows junctional problem at L1-L2 level. (B) Preoperative thoraco-lumbar spine lateral view shows junctional problem. (C) Posterior epidural disc fragment is detected with mild enhancement on sagittal MR enhancement image (arrow) (D) Margin of posterior epidural disc fragment is seen with enhancement at the posterior to thecal sac of L1-2 intervertebral disc space on axial MR enhancement image (arrow)
Fig. 2
(A) Intraoperative photography shows 1.5×1.8×2.0 cm-sized posteriorly migrated extradural disc fragment. (B) Photomicrograph shows disc degeneration (HE stain ×100)
References
-
Masaryk TJ, Ross JS, Modic MT, Boumphrey F, Bohlman H, Wilber G. High-resolution MR imaging of sequestered lumbar intervertebral disks. Am I Roentgenol 1988;150:1155–1162.
-
-
Schellinger D, Manz HJ, Vidic B, et al. Disk fragment migration. Radiology 1990;175:831–836.
-
-
Lutz JD, Smith RR, Jones HM. CT myelography of a fragment of a lumbar disk sequestered posterior to the thecal sac. AJNR Am J Neuroradiol 1990;11:610–611.
-
-
Bonaldi VM, Duong H, Starr MR, Sarazin L, Richardson J. Tophaceous gout of the lumbar spine mimicking an epidural abscess: MR features. AJNR Am J Neuroradiol 1996;17:1949–1952.
-
-
Liu SS, Williams KD, Drayer BP, Spetzler RF, Sonntag VK. Synovial cysts of the lumbosacral spine: diagnosis by MR imaging. AJNR Am J Neuroradiol 1989;10:1239–1242.
-