Pan Jianjiang, Wang Yue, Huang Yazeng
Spine Lab, Department of Orthopedic Surgery, The 1st Affiliated Hospital of Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China.
Department of Orthopedic Surgery, Zhejiang Provincial People's Hospital, 158# Shangtang Road, Hangzhou, 310014, China.
World J Surg Oncol. 2016 Apr 18;14:113. doi: 10.1186/s12957-016-0864-y.
Lumbar intervertebral disc herniation and spinal tumor are major pathologies that may cause back pain and radiculopathy. Neurological symptoms resulting from disc herniation and intradural spinal tumor together, however, are very rare.
We report a case of lumbar disc herniation which coexists with intradural schwannoma at the same spinal level in a 67-year-old man. The patient presented with persistent low back pain, sciatica, and weakness of the lower limbs. Contrast lumbar spine magnetic resonance (MR) imaging clearly delineated an intradural lesion and an extradural herniated disc at L3/4 level. Using a single posterior approach, both pathologies were addressed. Pathological studies confirmed the intradural lesion was schwannoma.
The case report highlights a rare concomitance of two symptomatic pathologies in a lumbar spine, which deserves clinical attention. Complete history, careful physical examination, and investigative measures, such as contrast MR imaging, are helpful to establish throughout diagnoses.
腰椎间盘突出症和脊柱肿瘤是可能导致背痛和神经根病的主要病症。然而，椎间盘突出症和硬脊膜内脊髓肿瘤共同导致的神经症状非常罕见。
我们报告一例67岁男性患者，腰椎间盘突出症与同一脊髓节段的硬脊膜内神经鞘瘤并存。患者表现为持续性腰痛、坐骨神经痛和下肢无力。腰椎磁共振成像（MR）造影清晰显示L3/4节段有硬脊膜内病变和硬膜外突出的椎间盘。采用单一后路手术处理了这两种病变。病理研究证实硬脊膜内病变为神经鞘瘤。
该病例报告突出了腰椎中两种有症状病症罕见的并存情况，值得临床关注。完整的病史、仔细的体格检查以及诸如磁共振成像造影等检查措施有助于做出全面诊断。
