Orthopedic & Trauma-Surgery Department, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Spine (Phila Pa 1976). 2011 Jul 1;36(15):E1033-7. doi: 10.1097/BRS.0b013e3181fee8d2.
Case report and review of the literature.
To report two additional cases with intradural cervical herniation and review the pertinent literature.
Intradural cervical disc herniation is rare and a total of 22 cases were reported in 2007. In searching the world literature on this topic, we found 27 cases of intradural cervical disc herniation in all.
Clinical history, physical examination, and radiographic findings of two patients with intradural cervical disc herniation were described, and corpectomy was performed in both cases. A review of the literature was completed.
The outcome of one case was gratifying, and at a 36-month follow-up, nearly a full recovery was obtained. But the other's condition was disappointing, whose postoperative MRI demonstrated high signal intensity in the spinal cord and adhesion of spinal cord to the posterior margin at C4 level.
Intradural cervical disc herniation is relatively rare, and the two additional cases updated the number of this condition to 29. It remains difficult to definitively diagnose the disease before surgery, but some indirect signs may indicate the cases. Corpectomy under a microscope as the first option in treatment of this disease is recommended once it is highly diagnosed. The pathogenesis of intradural cervical disc herniation remains to be further investigated. We presume that biochemical factors may play an important role in the pathogenesis.
病例报告及文献复习。
报告另外 2 例硬脊膜内颈椎间盘疝,并复习相关文献。
硬脊膜内颈椎间盘疝罕见,2007 年共报道 22 例。在对该主题的世界文献进行搜索时,我们总共发现了 27 例硬脊膜内颈椎间盘疝。
描述了 2 例硬脊膜内颈椎间盘疝患者的临床病史、体格检查和影像学发现,并对这 2 例患者均进行了前路椎体次全切除。完成了文献复习。
1 例患者的结果令人满意,在 36 个月的随访时,几乎完全恢复。但另 1 例患者的情况令人失望,其术后 MRI 显示 C4 水平脊髓高信号强度和脊髓与后缘粘连。
硬脊膜内颈椎间盘疝相对罕见,新增 2 例使该疾病的病例数达到 29 例。在术前仍难以明确诊断,但一些间接征象可能提示该病。一旦高度怀疑该病,建议将显微镜下前路椎体次全切除作为治疗该病的首选方法。硬脊膜内颈椎间盘疝的发病机制仍需进一步研究。我们推测生化因素可能在发病机制中起重要作用。