Lin Yu-Hsiang, Chen Der-Cherng, Chen Chao-Hsuan, Huang Hsiang-Ming, Cho Der-Yang
Division of Neurosurgery, China Medical University Hospital, Taichung, Taiwan, ROC.
Biomedicine (Taipei). 2021 Mar 1;11(1):56-59. doi: 10.37796/2211-8039.1080. eCollection 2021.
Intradural disc herniation (IDH) is an extremely rare condition. The authors report the case of a 53-year-old female who had neck and right shoulder pain associated with right-sided hemiparesis and hyperesthesia. Magnetic resonance imaging (MRI) of the cervical spine (C-spine) revealed central mass-like lesions that caused the; compression of the right side of the spinal cord. The posterior surgical approach was used to remove two pieces of IDH. After surgery, the muscle strength in the right upper limb improved from Grade 0/5 to 4+/5 without surgery-related complications. Although there are some reports in literature on the radiologic features of cervical IDH (including the Halo sign, Y-sign, hawk-beak sign, and crumble disc sign), it can be difficult to diagnose radiologically. We present the clinical image of the case along with a review of the literature to remind surgeons to consider IDH as a differential diagnosis when patients are affected by anterior intradural lesions.
硬膜内椎间盘突出症（IDH）是一种极其罕见的病症。作者报告了一例53岁女性病例，该患者伴有颈部和右肩部疼痛，并伴有右侧偏瘫和感觉过敏。颈椎磁共振成像（MRI）显示中央肿块样病变，导致脊髓右侧受压。采用后路手术方法切除了两块IDH。术后，右上肢肌力从0/5级提高到4+/5级，且无手术相关并发症。尽管文献中有一些关于颈椎IDH放射学特征的报道（包括晕征、Y征、鹰喙征和破碎椎间盘征），但放射学诊断可能具有挑战性。我们展示该病例的临床影像并回顾文献，以提醒外科医生，当患者出现硬膜内前部病变时，应将IDH作为鉴别诊断考虑在内。
