Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
J Orthop Traumatol. 2010 Dec;11(4):257-61. doi: 10.1007/s10195-010-0119-6. Epub 2010 Nov 20.
Erosion of spinal osseous structure, so-called scalloping, has been rarely reported associated with herniated nucleus pulposus (HNP). We report a rare case of HNP causing erosion of the spinal osseous structure (including lamina). The patient was an 81-year-old woman with 3-year history of low-back pain and left leg radiating pain. Muscle weakness of the left leg was also apparent. Computed tomography following myelography showed severe compression of the dural sac at the level of L3-L4; furthermore, erosion of the lamina, pedicle, and vertebral body was noted, indicating that the space-occupying mass was most probably a tumorous lesion. The mass also showed calcification inside. During the surgery, the mass was confirmed to be an HNP with calcification. Following resection, the pain disappeared. Surgeons should be aware of the possibility of scalloping of the vertebrae caused by HNP mimicking a tumorous lesion.
脊柱骨结构侵蚀,即所谓的“扇贝样变”,与椎间盘突出症(HNP)相关的报道很少见。我们报告了一例罕见的 HNP 导致脊柱骨结构(包括椎板)侵蚀的病例。患者为 81 岁女性,有 3 年腰痛和左下肢放射痛病史,左下肢肌肉无力也很明显。脊髓造影后的计算机断层扫描显示 L3-L4 水平的硬脑膜囊严重受压;此外,还注意到椎板、椎弓根和椎体的侵蚀,表明占位性病变很可能是肿瘤性病变。肿块内也有钙化。手术时,证实肿块为伴有钙化的 HNP。切除后,疼痛消失。外科医生应该意识到 HNP 引起的脊椎扇贝样变可能类似于肿瘤性病变。