Cho Hyung-Lea, Lee Sang-Ho, Kim Jin-Sung
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea.
Neurol Med Chir (Tokyo). 2011;51(1):67-71. doi: 10.2176/nmc.51.67.
Two patients presented with sciatica-like pain caused by thoracic disk herniation. Sciatica-like pain was the initial and major symptom in both patients, but careful neurological examination showed vague signs of upper motor neuron disturbance, and thoracic magnetic resonance (MR) imaging revealed disk herniations at the mid-thoracic level. After video-assisted thoracoscopic discectomy, the pain was completely improved. Thorough neurological examination and MR imagery of the thoracic spine, and if needed, even the cervical spine, are required if lumbar image findings do not correlate with the symptoms or physical examination.
两名患者因胸椎间盘突出症出现类似坐骨神经痛的疼痛。类似坐骨神经痛的疼痛是两名患者的初始及主要症状,但仔细的神经学检查显示有上运动神经元紊乱的模糊迹象,胸部磁共振成像(MR)显示胸段中部水平的椎间盘突出。在电视辅助胸腔镜椎间盘切除术后,疼痛完全缓解。如果腰椎影像学检查结果与症状或体格检查不相符,则需要对胸椎进行全面的神经学检查和磁共振成像检查,如有必要,甚至还需对颈椎进行检查。