Zhou Jun-Ge
Department of Neurosurgery, General Hospital of The Yangtze River Shipping, Wuhan Brain Hospital, Wuhan 430010, Hubei Province, China.
World J Clin Cases. 2025 Jun 6;13(16):103373. doi: 10.12998/wjcc.v13.i16.103373.
Lumbar disc extrusion, a common spinal disorder, is particularly uncommon in its severely displaced form, especially in young patients. This condition can pose diagnostic challenges due to its nonspecific presentation.
A 36-year-old male patient presented with persistent low back pain and radiating leg pain lasting half a month, which had worsened over the previous four days. Lumbar magnetic resonance imaging scans showed an abnormal signal within the vertebral canal at the L3 level, suggesting either a disc cyst or an epidural hematoma. Based on these findings, the patient was provisionally diagnosed with either condition. Surgical exploration was conducted, revealing an extruded lumbar disc, which was subsequently excised. Following surgery, the patient's symptoms completely resolved.
High-grade lumbar disc extrusion in young patients is rare but should be considered in sedentary, physically inactive individuals presenting with lumbocrural pain and abnormal magnetic resonance imaging findings. Early and accurate diagnosis is crucial to avoid misdiagnosis, and prompt open surgery may be necessary in severe cases to alleviate symptoms. The case highlights the impotance of a thorough diagnostic workup and timely surgical intervention in managing such rare but potentially severe spinal disorders.
腰椎间盘突出是一种常见的脊柱疾病，其严重移位形式尤其罕见，在年轻患者中更为少见。由于其表现不具特异性，这种情况可能带来诊断挑战。
一名36岁男性患者出现持续半个月的下腰痛和放射性腿痛，在过去四天里病情加重。腰椎磁共振成像扫描显示L3水平椎管内有异常信号，提示可能为椎间盘囊肿或硬膜外血肿。基于这些发现，该患者被初步诊断为这两种病症中的一种。进行了手术探查，发现是一枚突出的腰椎间盘，随后将其切除。术后，患者症状完全缓解。
年轻患者中的重度腰椎间盘突出较为罕见，但对于出现腰腿痛且磁共振成像结果异常的久坐、缺乏身体活动的个体应予以考虑。早期准确诊断对于避免误诊至关重要，严重病例可能需要及时进行开放手术以缓解症状。该病例凸显了在处理此类罕见但可能严重的脊柱疾病时进行全面诊断检查和及时手术干预的重要性。
