| Unusual sequestered disc fragments simulating spinal tumors and other space-occupying lesions. Clinical article. | |
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MedLine Citation:
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PMID: 19569939 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: In this study the authors evaluated disease incidence, treatment, and outcome in patients with unusual sequestered disc fragments simulating spinal tumors or another space-occupying lesion on preoperative MR imaging. METHODS: The authors retrospectively reviewed data from the last 3000 patients with a histological diagnosis of disc herniation. Patients with preoperative MR imaging findings that simulated a spinal tumor or other space-occupying lesion were individually analyzed. RESULTS: In 11 patients (0.4%), MR imaging findings of unusual sequestered disc fragments were mistaken for another spinal space-occupying lesion. In 8 cases, the fragments had migrated to the posterior spinal space; in 3 cases, into the dural sac. In 3 patients, the fragments were distant from the original disc space. A heterogeneous mass was revealed with low-intensity or isointense signal on T1-weighted MR images as well as low signal (4 cases) or high signal (7 cases) intensity on T2-weighted images, relative to the spinal structures. A slight diffuse or peripheral Gd enhancement rim was observed in 7 patients. Disc fragments were located in the cervical (1 patient), thoracic (2 patients), and lumbar (8 patients) spine. All lesions were completely removed. Discectomy was required in 4 patients. A complete recovery occurred in 8 patients and a minor neurological deficit remained in 3. CONCLUSIONS: Atypically located disc herniations should be considered in the differential diagnosis in patients with MR imaging data indicating spinal space-occupying disorders. All of these lesions, even those intradurally located, can be completely removed. |
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Authors:
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Mario Nazareno Carvi y Nievas; Hans-Georg Hoellerhage |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurosurgery. Spine Volume: 11 ISSN: 1547-5654 ISO Abbreviation: - Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-02 Completed Date: 2009-08-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101223545 Medline TA: J Neurosurg Spine Country: United States |
Other Details:
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Languages: eng Pagination: 42-8 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Städtischen Klinikum, Frankfurt am Main Höchst, Germany. MCNievas@t-online.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Diagnosis, Differential Female Humans Intervertebral Disk Displacement / diagnosis*, surgery Magnetic Resonance Imaging* Male Middle Aged Retrospective Studies Spinal Neoplasms / diagnosis |
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