J Korean Soc Spine Surg. 2008 Sep;15(3):190-193. Korean.
Published online Sep 30, 2008.
Copyright © 2008 Korean Society of Spine Surgery
Case Report

Paraparesis due to Posterior Migration of Ruptured Disc in the Adjacent Segment after Spinal Fusion - Unusual Junctional Problem -

Ye-Soo Park, M.D., Joon-Hwan Lee, M.D., Chang-Nam Kang, M.D.,# Jae-Lim Cho, M.D.,# and Yong-Wook Park, M.D.$
    • Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Korea.
    • #Department of Orthopaedic Surgery, College of Medicine, Hanyang University, Seoul, Korea.
    • $Department of Pathology, Hanyang University Guri Hospital, Guri, Korea.

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.

Keywords
Posterior migration; Ruptured disc; Spinal fusion; Paraparesis

Figures

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)

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