Bouya Soueilem Mohamed, Djoubairou Ben Ousmanou, Okacha Naama, Gazzaz Miloudi, El Mostarchid Brahim
Department of Neurosurgery, Mohammed V Military Teaching Hospital, Mohammed V University, School of Medicine, Hay Riyad, 1018 Rabat, Morocco.
Pan Afr Med J. 2015 Jun 2;21:80. doi: 10.11604/pamj.2015.21.80.6993. eCollection 2015.
Disc fragments are well known to migrate to superior, inferior, or lateral sites in the anterior epidural space, posterior epidural migrated lumbar disc fragments is an extremely rare disorder. Posterior epidural migrated lumbar disc fragments are often confused with other posterior epidural space-occupying lesions (cysts, abscesses, tumors, and hematomas). We reported the case of a 52- year-old man presented with progressive not systematizes bilateral radiculopathy complicated one week before admission a difficulty dorsiflexion prevents the start, and the stared to use crutches. Clinical examination revealed steppage gait and a strength score of 3/5 on dorsiflexion of feet. MR imaging of lumbar spine showed right posterolateral epidural mass that compressed the dural sac at the L3-4 level. Patient underwent surgery using posterior approach, an L3 laminectomy was performed, the extruded disk fragment was gently removed and L3-L4 interspace was explored. Histopathology confirmed the (PEMLIF). Postoperative course was uneventful.
椎间盘碎片向前硬膜外间隙的上、下或外侧部位迁移是众所周知的,而后硬膜外迁移的腰椎间盘碎片是一种极其罕见的疾病。后硬膜外迁移的腰椎间盘碎片常与其他后硬膜外占位性病变(囊肿、脓肿、肿瘤和血肿)相混淆。我们报告了一例52岁男性病例,该患者表现为进行性非系统性双侧神经根病,入院前一周出现足背屈困难,开始使用拐杖。临床检查发现有跨越步态,足部背屈时肌力评分为3/5。腰椎磁共振成像显示L3-4水平右侧后外侧硬膜外肿块压迫硬膜囊。患者采用后路手术,行L3椎板切除术,轻柔地取出突出的椎间盘碎片并探查L3-L4间隙。组织病理学证实为(后硬膜外迁移的腰椎间盘碎片)。术后过程顺利。