| Posterior Epidural Migration of Sequestrated Lumbar Disc Fragments into The Bilateral Facet Joints. | |
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MedLine Citation:
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PMID: 21606882 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND IMPORTANCE:: Symptomatic lumbar disc herniation is common. Migration of a free disc fragment is usually found in rostral, caudal, or lateral directions. Posterior epidural migration is very rare. We report the first case with posterior epidural migration and sequestration into bilateral facet joints of a free disc fragment. CLINICAL PRESENTATION:: A 78-year-old female presented with low back pain and right leg pain. Plain radiographs showed lumbar spondylolisthesis. Magnetic resonance imaging revealed a posterior epidural mass and intrafacet mass, which was hypointense on T1-weighted images and hyperintense on T2-weighted images. The lesion in the left L3-4 facet joint had rim enhancement whereas the right one was not contrasted after gadolinium injection. Preoperative differential diagnosis included abscess, tumor, hematoma, or synovial cyst. We performed a hybrid technique with L3-4, L4-5 interbody cages fusion for spondylolisthesis and L3-S1 Dynesys flexible rod system for multisegment degenerative disc disease. The lesion proved to be an epidural disc fragment with sequestration into bilateral facet joints. CONCLUSION:: A free disc fragment should be considered in the differential diagnosis of posterior epidural lesions, and even in the facet joint. |
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Authors:
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Tzuu-Yuan Huang; Kung-Shing Lee; Tai-Hsin Tsai; Yu-Feng Su; Shiuh-Lin Hwang |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-19 |
Journal Detail:
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Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1. Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University, Hospital, Kaohsiung, Taiwan; 2. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 3. Department of Surgery, Sin-Lau Hospital, Tainan, Taiwan. |
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