Giblin Erica M, Hochheiser Gary M
Department of Surgery, Baystate Thoracic Surgery Associates, Baystate Medical Center, Springfield, MA 01107, USA.
Pediatr Emerg Care. 2008 Aug;24(8):550-3. doi: 10.1097/PEC.0b013e318180ff1d.
Thoracic intervertebral disk herniation is an uncommon entity. Acute presentation of this entity in the pediatric population is exceptionally rare. Given the infrequent prevalence, accurate diagnosis of acute symptomatic thoracic disk herniation can be difficult.
The purpose of this article is to describe the presentation of acute nontraumatic thoracic disk herniation in a pediatric patient and the diagnostic workup and surgical management of this rare entity.
This is a case report regarding a pediatric patient with nontraumatic acutely symptomatic thoracic disk herniation. The order of diagnostic studies and method of surgical decompression used are described. Progressive follow-up neurological improvement is detailed in the report.
A 16-year-old adolescent girl with acutely symptomatic paramedian disk herniation at T10 to T11 underwent left thoracotomy followed by microdiscectomy. Decompression of T10 to T11 was followed by fusion of T10 to T11 with rib strut graft.
Postoperatively, the patient recovered near-complete resolution of bilateral lower extremity paralysis and dysesthesias.
Thoracic intervertebral disk herniation is a rare phenomenon. It is a particularly uncommon entity in the pediatric population. As such, the diagnosis and management of thoracic disk herniation can be a considerable challenge. As illustrated in our case report, the clinician's focus should not exclusively rest on lumbar disk pathology as the etiology for such rapidly evolving neuromuscular deficits. Thoracic disk herniation must be included in the differential diagnosis, and appropriate diagnostic workup should be instituted in an expeditious manner. Plain radiographic studies may not delineate the causative factor of pathology, and emergent magnetic resonance imaging can aid in obtaining a timely diagnosis. Early intervention and decompression have been shown to significantly improve functional recovery.
胸椎间盘突出症并不常见。在儿科人群中急性发作这种疾病极为罕见。鉴于其发病率低，准确诊断急性症状性胸椎间盘突出症可能具有挑战性。
本文旨在描述一名儿科患者急性非创伤性胸椎间盘突出症的表现以及这种罕见疾病的诊断检查和手术治疗。
这是一篇关于一名患有非创伤性急性症状性胸椎间盘突出症的儿科患者的病例报告。描述了诊断研究的顺序和所采用的手术减压方法。报告中详细阐述了逐步的随访神经功能改善情况。
一名16岁青少年女性，在T10至T11节段出现急性症状性旁中央椎间盘突出，接受了左胸开胸手术，随后进行了显微椎间盘切除术。在对T10至T11进行减压后，采用肋骨支撑移植对T10至T11进行融合。
术后，患者双侧下肢瘫痪和感觉异常几乎完全缓解。
胸椎间盘突出症是一种罕见现象。在儿科人群中尤其不常见。因此，胸椎间盘突出症的诊断和治疗可能是一项相当大的挑战。如我们的病例报告所示，临床医生不应仅将腰椎间盘病变作为这种快速发展的神经肌肉缺陷的病因。胸椎间盘突出症必须纳入鉴别诊断，并应迅速进行适当的诊断检查。普通X线检查可能无法明确病理的致病因素，而紧急磁共振成像有助于及时诊断。早期干预和减压已被证明能显著改善功能恢复。
