Liu Wanguo, Tang Chenglin, Liu Lidi, Zhu Qing San, Huang Lan Feng
Department of Orthopaedic Surgery, China-Japan Union Hospital, Jilin University, 829 XinMin St, Changchun, 130021, China.
Department of Spinal Surgery, The First Hospital, Jilin University, 71 XinMin St, Changchun, 130021, China.
Childs Nerv Syst. 2016 Apr;32(4):749-52. doi: 10.1007/s00381-015-2886-0. Epub 2015 Aug 29.
The purpose of this case report is to present a very atypical case of cervical intervertebral disc calcification (IDC) with extreme lateral herniated calcification in a child. This is the first ever reported case in which T2-weighted signal intensity of the involved disc was restored to normal after a 2-year follow-up.
A 10-year-old girl presented with neck pain and right upper limb numbness for 2 months. The initial computed tomography (CT) images on admission showed calcified nucleus pulposus with extreme lateral herniated calcification at the C6-C7 level. Meanwhile, T2-weighted magnetic resonance imaging (MRI) revealed decreased signal intensity of the involved disc. The patient was treated conservatively with nonsteroidal anti-inflammatory drugs and jaw-occipital belt traction for 2 weeks. The cervical CT and MRI scans were repeated at 2-year follow-up.
Her clinical symptoms were completely resolved after 2 weeks. At 2-year follow-up, CT and MRI images demonstrated that calcification was completely absorbed and T2-weighted signal intensity of the C6-C7 disc was restored back to normal.
Cervical IDC combined with extreme lateral herniated calcification is extremely rare in children. The recovery of signal intensity of intervertebral disc on MRI may provide further support to the feasibility of conservative treatment of IDC.
本病例报告旨在呈现一例儿童颈椎间盘钙化(IDC)合并极外侧钙化性椎间盘突出的非常罕见的病例。这是首例有报道称受累椎间盘的T2加权信号强度在2年随访后恢复正常的病例。
一名10岁女孩因颈部疼痛和右上肢麻木2个月就诊。入院时的初始计算机断层扫描(CT)图像显示C6 - C7水平有钙化的髓核伴极外侧钙化性椎间盘突出。同时,T2加权磁共振成像(MRI)显示受累椎间盘信号强度降低。患者接受了2周的非甾体类抗炎药和颌枕带牵引保守治疗。2年随访时重复进行颈椎CT和MRI扫描。
2周后她的临床症状完全缓解。2年随访时,CT和MRI图像显示钙化完全吸收,C6 - C7椎间盘的T2加权信号强度恢复正常。
儿童颈椎IDC合并极外侧钙化性椎间盘突出极为罕见。MRI上椎间盘信号强度的恢复可能为IDC保守治疗的可行性提供进一步支持。