Chu Eric Chun-Pu, Lin Andy, Huang Kevin Hsu Kai, Cheung Gordon, Lee Wai Ting
Chiropractic and Physiotherapy Department, New York Medical Group, Hong Kong, HKG.
Cureus. 2023 Mar 22;15(3):e36545. doi: 10.7759/cureus.36545. eCollection 2023 Mar.
Lumbar disc herniation (LDH) is prevalent among adults aged 25-55 years who spend a considerable proportion of their time sitting or standing with heavy workloads. We report the case of a 33-year-old male waiter with severe LDH, causing compression of the nerve roots and spinal cord with neurological dysfunction, who presented to a chiropractic clinic. Magnetic resonance imaging (MRI) revealed a radiological differential diagnosis comprising LDH and an epidural mass lesion. To rule out serious pathology, a second MRI with contrast was ordered, which confirmed the diagnosis of severe LDH. Diagnosing large LDH may be challenging, and severe disc herniation often mimics spinal tumors. This study offers insights into the differential diagnosis of LDH and spinal tumors, as well as the design of a treatment strategy for severe LDH in the chiropractic clinic.
腰椎间盘突出症（LDH）在25至55岁的成年人中很常见，这些人大部分时间都坐着或站着，工作负荷很重。我们报告了一名33岁男性服务员的病例，他患有严重的腰椎间盘突出症，导致神经根和脊髓受压并伴有神经功能障碍，他前往一家整脊诊所就诊。磁共振成像（MRI）显示出包括腰椎间盘突出症和硬膜外肿块病变的放射学鉴别诊断。为排除严重病变，又进行了一次增强MRI检查，确诊为严重腰椎间盘突出症。诊断大型腰椎间盘突出症可能具有挑战性，严重的椎间盘突出症常与脊柱肿瘤相似。本研究为腰椎间盘突出症和脊柱肿瘤的鉴别诊断以及整脊诊所中严重腰椎间盘突出症治疗策略的设计提供了见解。
