Derincek Alihan, Ozalay Metin, Sen Orhan, Pourbagher Ayşin
Baskent University School of Medicine, Department of Orthopaedics and Traumatology, Adana Medical Center, Adana, Turkey.
Acta Orthop Belg. 2009 Jun;75(3):423-7.
A 60-year-old woman complained of low back pain radiating to both buttocks and to the anterior aspect of the left thigh. MRI showed a left posterolateral epidural mass at the L1-L2 level. An epidural abscess was suspected, but the biochemistry was normal. Excision yielded complete relief of symptoms. Pathological examination demonstrated that the specimen was a migrated disc fragment. The authors found 29 other cases of disc migration to the posterior epidural space; two of these were at the thoracic level. Eleven of the 27 lumbar cases (40%) were complicated with Cauda Equina Syndrome (CES). MRI is the method of choice to make the diagnosis. The differential diagnosis includes tumour, haematoma and abscess.
一名60岁女性主诉下背部疼痛，疼痛放射至双侧臀部及左大腿前侧。磁共振成像（MRI）显示L1-L2水平左侧后外侧硬膜外肿块。怀疑为硬膜外脓肿，但生化检查正常。手术切除后症状完全缓解。病理检查显示标本为移位的椎间盘碎片。作者还发现了另外29例椎间盘向后硬膜外间隙移位的病例；其中2例发生在胸段。27例腰椎病例中有11例（40%）合并马尾综合征（CES）。MRI是进行诊断的首选方法。鉴别诊断包括肿瘤、血肿和脓肿。
