Hamasaki Takahiko, Baba Itsushi, Tanaka Shin, Sumida Tadayoshi, Manabe Hideki, Tanaka Nobuhiro, Ochi Mitsuo
Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Spine (Phila Pa 1976). 2005 Oct 15;30(20):E591-6. doi: 10.1097/01.brs.0000179310.39568.29.
A retrospective study of 15 cases of pure foraminal type cervical disc herniation (CDH) was performed.
The objectives were to describe the clinical characteristics and to assess the radiologic findings.
Although foraminal lumbar disc herniation has been reported, pure foraminal-type CDH has not been fully elucidated. It is not only a rare condition but also a difficult one to diagnose.
All patients underwent MRI, CT myelography (CTM), and CT discography (CTD). Herniated discs were removed by the posterior approach. Clinical symptoms were evaluated at preoperative and postoperative period.
On MRI, 2 cases were positive, 6 cases were suspected, and 7 cases were negative. On CTM, 7 cases were positive and 8 cases were negative; and on CTD, all cases were positive. As to the association between the herniated disc and posterior longitudinal ligament, 12 cases were intraligamentous. The association between the herniated disc and nerve root revealed that 10 discs were at the axillary portion of the nerve root.
Pure foraminal-type CDH may be overlooked with conventional MRI or CTM, so CTD should be performed. It provides valuable and additional information in difficult or ambiguous cases such as pure foraminal type.
对15例单纯椎间孔型颈椎间盘突出症(CDH)进行回顾性研究。
描述其临床特征并评估影像学表现。
虽然已有关于椎间孔型腰椎间盘突出症的报道,但单纯椎间孔型CDH尚未得到充分阐明。它不仅罕见,而且诊断困难。
所有患者均接受了磁共振成像(MRI)、CT脊髓造影(CTM)和CT椎间盘造影(CTD)检查。通过后路手术摘除突出的椎间盘。在术前和术后评估临床症状。
在MRI检查中,2例呈阳性,6例疑似阳性,7例阴性。在CTM检查中,7例阳性,8例阴性;在CTD检查中,所有病例均为阳性。关于突出椎间盘与后纵韧带的关系,12例为韧带内型。突出椎间盘与神经根的关系显示,10个椎间盘位于神经根的腋部。
单纯椎间孔型CDH可能会被传统的MRI或CTM漏诊,因此应进行CTD检查。它在诸如单纯椎间孔型等疑难或不明确的病例中提供了有价值的额外信息。