Kozaki Takuhei, Nagata Keiji, Miyake Ryo, Kozaki Takahiro, Yamada Hiroshi
Department of Orthopaedic Surgery Wakayama Medical University, 811-1 Kimiidera, Wakayama, Japan.
J Orthop Case Rep. 2023 Dec;13(12):125-129. doi: 10.13107/jocr.2023.v13.i12.4104.
Disc sequestration is well known as a perforation of the fibrous ring and posterior longitudinal ligament, and migration of the fragment to the epidural space.
A 62-year-old man complained of increased pain and hypoesthesia and muscle weakness of the left lower limb that had started 1 month before. Magnetic resonance imaging revealed a tumor-like mass at the L2-3 level on the posterior side of the dura. The fragment was strongly adhered to the dural sac and was resected piece by piece. Disc herniation recognized at L2-3 compressed the left L3 nerve root and was removed. The histopathological diagnosis was consistent with a degenerated intervertebral disc. All symptoms improved after the surgery.
There are few reports about the posterior migrated disc herniation at higher lumbar level. It may be associated with fused segments from L4 to the pelvis due to the previous surgery, which impacted the adjacent segment.
椎间盘游离是指纤维环和后纵韧带穿孔,碎片迁移至硬膜外间隙。
一名62岁男性主诉1个月前开始出现左下肢疼痛加剧、感觉减退和肌肉无力。磁共振成像显示硬脊膜后侧L2-3水平有一个肿瘤样肿块。碎片与硬脊膜囊紧密粘连,遂逐块切除。L2-3水平的椎间盘突出压迫左侧L3神经根,予以切除。组织病理学诊断与退变的椎间盘一致。术后所有症状均有改善。
关于高位腰椎水平椎间盘突出向后迁移的报道较少。它可能与既往手术导致的L4至骨盆融合节段有关,这影响了相邻节段。