Document Detail

Unusual sequestered disc fragments simulating spinal tumors and other space-occupying lesions. Clinical article.
MedLine Citation:
PMID:  19569939     Owner:  NLM     Status:  MEDLINE    
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.
Mario Nazareno Carvi y Nievas; Hans-Georg Hoellerhage
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  11     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-02     Completed Date:  2009-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-8     Citation Subset:  IM    
Department of Neurosurgery, Städtischen Klinikum, Frankfurt am Main Höchst, Germany.
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MeSH Terms
Aged, 80 and over
Diagnosis, Differential
Intervertebral Disk Displacement / diagnosis*,  surgery
Magnetic Resonance Imaging*
Middle Aged
Retrospective Studies
Spinal Neoplasms / diagnosis

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