Unusual Presentation of Bilateral Foraminal Disc Herniation.
- Author:
Sung Woo CHOI
1
;
Jae Chul LEE
;
Hyung Suk CHOI
;
Byung Joon SHIN
Author Information
1. Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea. swchoi@schmc.ac.kr
- Publication Type:Case Report
- Keywords:
Intervertebral disc;
Foramen;
Neurilemmoma;
Pedicle;
Diagnostic errors
- MeSH:
Cytochrome P-450 CYP1A1;
Diagnostic Errors;
Female;
Humans;
Intervertebral Disc;
Low Back Pain;
Magnetic Resonance Imaging;
Middle Aged;
Neurilemmoma;
Pectinidae;
Pedicle Screws;
Seoul
- From:Soonchunhyang Medical Science
2016;22(2):180-184
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 64-year-old woman was admitted to Soonchunhyang University Seoul Hospital due to the aggravation of bilateral radicular pain for one month prior to her visit. She had a 30 years history of low back pain and intermittent bilateral radiating pain. A magnetic resonance imaging scan revealed a bilateral space-occupying lesion in the L5 foramen. A sagittal computed tomography scan showed a disc space-narrowing, vacuum-containing, and widening of the neural exit foramen with thinning of the pedicle and posterior vertebral body scalloping. An axial scan showed that the space-occupying lesion contained calcification and had eroded the surrounding bony structure. During surgical exploration, the atrophic L5 nerve root was identified over the mass-like lesion, and the lesion was shown to be a result of a hard, extruded disc fragment. A bilateral foraminal disc is a very rare condition that when it progresses chronically and gradually, can erode adjacent bony structures. Specific precautions are necessary during fusion surgery with a pedicle screw.
