Document Detail

Cervical intradural disc herniation.
MedLine Citation:
PMID:  11246389     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: A case report of anterior en bloc resected cervical intradural disc herniation and a review of the literature. OBJECTIVE: To discuss the pathogenesis of cervical intradural disc herniation. SUMMARY OF BACKGROUND DATA: Including this study case, only 17 cases of cervical intradural disc herniation have been reported. There have been few detailed reports concerning the pathogenesis of cervical intradural disc herniation. METHODS: A cervical intradural disc herniation at C6-C7, with localized hypertrophy and segmentally ossified posterior longitudinal ligament, is reported in a 45-year-old man who had Brown-Sequard syndrome diagnosed on neurologic examination. Neuroradiologic, operative, and histologic findings, particularly the pathology of the anterior en bloc resected posterior vertebral portion of C6 and C7, were evaluated for discussion of the pathogenesis. RESULTS: Adhesion of dura mater and hypertrophic posterior longitudinal ligament was observed around a perforated portion of the herniated disc, and histologic study showed irregularity in fiber alignment accompanied by scattered inflammatory cell infiltration and hypertrophy in the posterior longitudinal ligament. The cervical intradural disc herniation was removed successfully and followed by C5-Th1 anterior interbody fusion with fibular strut graft. Neurologic recovery was complete except for minor residual sensory disturbance in the leg 7 years after the surgery. CONCLUSIONS: Cervical intradural disc herniation is an extremely rare condition. The pathogenesis remains obscure. Only 16 cases have been reported in the literature, and there has been little discussion concerning the local pathology of the herniated portion. The pathogenesis of the disease in the patient reported here was considered to be the adhesion and fragility of dura mater and posterior longitudinal ligament. This was caused by hypertrophy, with chronic inflammation and ossification of the posterior longitudinal ligament sustaining chronic mechanical irritation to the dura mater, leading to perforation of the herniated disc by an accidental force.
Y Iwamura; K Onari; S Kondo; R Inasaka; H Horii
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spine     Volume:  26     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-14     Completed Date:  2001-05-21     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  698-702     Citation Subset:  IM    
Department of Orthopedic Surgery, Yokohama Ekisaikai Hospital, Kanagawa, Japan.
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MeSH Terms
Cervical Vertebrae / pathology*,  radiography,  surgery
Dura Mater / pathology*,  radiography,  surgery
Intervertebral Disk / pathology*,  radiography,  surgery
Intervertebral Disk Displacement / pathology*,  radiography,  surgery
Longitudinal Ligaments / pathology,  radiography,  surgery
Magnetic Resonance Imaging
Middle Aged
Postoperative Complications / etiology,  physiopathology
Spinal Canal / pathology,  radiography,  surgery
Spinal Cord Compression / etiology,  pathology,  surgery
Spinal Fusion / methods
Subdural Space / pathology,  radiography,  surgery
Tomography, X-Ray Computed
Treatment Outcome

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