Mobbs Ralph J, Steel T R
Prince of Wales Hospital, Peripheral Nerve Research Foundation, 3 Wansey Road, Randwick, Sydney, NSW 2031, Australia.
J Clin Neurosci. 2007 Jun;14(6):581-4. doi: 10.1016/j.jocn.2006.04.002.
We illustrate a patient with a migrating lumbar disc fragment that caused a change in radicular symptoms from the L3 nerve root on one side to the L5 nerve root on the contralateral side, documented by magnetic resonance imaging (MRI). Our patient presented with 3 months of L3 pain on the right side with sensory and motor changes. Over a 24-hour time period, the right leg pain disappeared and he developed left leg pain attributable to left L5 nerve root compression. Investigation with MRI revealed an epidural mass, which was hypointense on Tl-weighted and T2-weighted images that had migrated, initially compressing the right L3 nerve root, to now compress the left L5 nerve root. The patient did not wish to pursue surgery. Disc fragment migration patterns are discussed. We conclude that extruded disc fragments may migrate distant from their initial origin.
我们展示了一名患有腰椎间盘碎片移位的患者,磁共振成像(MRI)记录显示,该碎片导致神经根症状从一侧的L3神经根改变为对侧的L5神经根。我们的患者出现右侧L3疼痛伴感觉和运动改变3个月。在24小时内,右腿疼痛消失,他出现了左腿疼痛,这归因于左侧L5神经根受压。MRI检查显示硬膜外有一个肿块,在T1加权和T2加权图像上呈低信号,该肿块已经移位,最初压迫右侧L3神经根,现在压迫左侧L5神经根。患者不希望接受手术。文中讨论了椎间盘碎片的移位模式。我们得出结论,突出的椎间盘碎片可能会从其最初的位置远处移位。