Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament

Wang, Dachuan; Wang, Haifeng; Shen, Wei

doi:10.1155/2014/256207

Cited by 7 publications

(13 citation statements)

References 10 publications

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“…In 2010, Hsieh et al6 reported a patient with OPLL who developed cervical IDH after spinal manipulation. Wang et al and Baudracco et al have reported spontaneous cervical IDH in patients with OPLL 5,7. In this article, we report a woman with OPLL who developed cervical IDH and Brown-Séquard syndrome following minor trauma.…”

Section: Introductionmentioning

confidence: 64%

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<p>Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review</p>

Rong¹,

Wang²,

Sui³

et al. 2019

JPR

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Objective To report a rare case of cervical intradural disc herniation (IDH) with Brown-Séquard syndrome and to review the related literature. Methods Pathogenesis, preoperative diagnosis, and the surgical technique are discussed, and previous literature reports are reviewed. Results A 44-year-old woman complained of weakness of the left upper and lower extremities and paresthesias in the right limbs after a bicycle ride 3 days earlier. She had a history of neck pain for 2 years prior. CT showed obvious ossification of the posterior longitudinal ligament (OPLL), and MRI revealed C3-7 disc herniations, with a positive “halo sign” around the herniated C4/5. We performed emergency decompression through anterior cervical corpectomy, and vertebrotomy decompression and fusion. At review 3 months after surgery, the patient’s neck pain was markedly relieved, and motor strength in the limbs had improved. At 1 year after surgery, she had recovered completely. Conclusion Cervical IDH is a rare condition that may be related to the traumatic inflammatory response and OPLL. Relatively rare imaging features such as the hawk-beak sign, halo sign, Y sign, and epidural gas sign could help in preoperative diagnosis. Prompt anterior cervical decompression is the preferred treatment for this condition.

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Section: Introductionmentioning

confidence: 64%

“…The first case of cervical IDH was reported in 1959 4. The pathogenetic mechanism of cervical IDH is unclear, but ossification of the posterior longitudinal ligament (OPLL) and trauma are probably involved 5…”

Section: Introductionmentioning

confidence: 99%

<p>Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review</p>

Rong¹,

Wang²,

Sui³

et al. 2019

JPR

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“…BSS resulting from cervical IDH is even more rarely seen, with only 14 cases we could find. [ 2 , 7 – 10 , 16 – 18 , 32 , 41 , 46 ] The prognoses for those cases were supposed to be worse. Though most cases of BSS caused by IDH resulted in incomplete recovery, the outcomes were still relatively acceptable without apparent disturbance to daily life.…”

Section: Discussionmentioning

confidence: 99%

Cervical disc herniation causing Brown-Sequard syndrome

Zeng

Ren²,

Wan³

et al. 2018

Medicine

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Rationale:Brown-Sequard syndrome (BSS) is manifested as ipsilateral motor deficit and contralateral sensory loss. BSS caused by herniated cervical disc is extremely rare and easily be misdiagnosed, and clinical features of this problem were not fully understood.Patient concerns:A 57-year-old man presented with a 3-month history of weakness in his right arm, and he experienced progressive right hemiparesis at 2 days before admission, along with contralateral deficit in sensation of pain and temperature below T2.Diagnoses:Magnetic Resonance Imaging (MRI) showed severe cord compression due to a large paracentral extradural C4-C5 cervical disc herniation (CDH).Interventions:Subtotal cervical corpectomy, decompression, and fusion through anterior approach were performed. The patient recovered rapidly after surgery.Outcomes:Complete recovery of sensory and motor functions was obtained at a 4-months follow-up after surgery.Lessons:Our case, along with a review of the literature, highlights that careful medical history inquiries, detailed neurologic examinations, and cervical spinal MRI scans are essential for diagnosis of CDH caused BSS. Prompt surgical decompression according to individual condition is commonly warranted. Early diagnosis with prompt surgical decompression could lead to favorable recovery.

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“…Some authors have reported cases of cervical IDH in patients with ossification of PLL. 9 , 10 They suggested that PLL hypertrophy and ossification can cause chronic mechanical irritation to the dura, particularly if it is already congenitally attached to the ligament.…”

Section: Discussionmentioning

confidence: 99%

“…According to previous reports, anterior cervical discectomy and fusion is superior to posterior decompression in terms of operative procedure and outcome. 1 , 10 , 14 Since the anterior approach directly accesses the affected disc, it facilitates removal of extruded disc material and dura repair.…”

Section: Discussionmentioning

confidence: 99%

Cervical Intradural Disc Herniation Causing Progressive Quadriparesis After Spinal Manipulation Therapy

Yang

Eun

2016

Medicine

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Cervical intradural disc herniation (IDH) is an extremely rare condition, comprising only 0.27% of all disc herniations. Three percent of IDHs occur in the cervical, 5% in the thoracic, and over 92% in the lumbar spinal canal. There have been a total of 31 cervical IDHs reported in the literature. The pathogenesis and imaging characteristics of IDH are not fully understood. A preoperative diagnosis is key to facilitating prompt intradural exploration in patients with ambivalent findings, as well as in preventing reoperation. The purpose of reporting our case is to remind clinicians to consider the possibility of cervical IDH during spinal manipulation therapy in patient with chronic neck pain.The patient signed informed consent for publication of this case report and any accompanying image. The ethical approval of this study was waived by the ethics committee of Chonbuk National University Hospital, because this study was case report and the number of patients was <3.A 32-year-old man was transferred our emergency department with progressive quadriparesis. He had no history of trauma, but had received physical therapy with spinal manipulation for chronic neck pain over the course of a month. The day prior, he had noticed neck pain and tingling in the bilateral upper and lower extremities during the manipulation procedure. The following day, he presented with bilateral weakness of all 4 extremities, which rendered him unable to walk. Neurological examination demonstrated a positive Hoffmann sign and ankle clonus bilaterally, hypoesthesia below the C5 dermatome, 3/5 strength in the bilateral upper extremities, and 2/5 strength in the lower extremities. This motor weakness was progressive, and he further complained of voiding difficulty.Urgent magnetic resonance imaging (MRI) of the cervical spine revealed large, central disc herniations at C4–C5 and C5–C6 that caused severe spinal cord compression and surrounding edema. We performed C4–C5–C6 anterior cervical discectomy and fusion.The patient's limb weakness improved rapidly within 1 day postoperatively, and he was discharged 4 weeks later. At his 12-month follow-up, the patient had recovered nearly full muscle power.We presented an extremely rare case of cervical IDH causing progressive quadriparesis after excessive spinal manipulation therapy. The presence of a “halo” and “Y-sign” were useful MRI markers for cervical IDH in this case.

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Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament

Cited by 7 publications

References 10 publications

<p>Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review</p>

<p>Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review</p>

Cervical disc herniation causing Brown-Sequard syndrome

Cervical Intradural Disc Herniation Causing Progressive Quadriparesis After Spinal Manipulation Therapy

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