Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament
Intradural herniation of a cervical disc is rare; less than 35 cases have been reported to date. A 52-year-old man with preexisting ossification of posterior longitudinal ligament developed severe neck pain with Lt hemiparesis while asleep. Neurological exam was consistent with Brown-Séquard syndrom...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2014/256207 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832563909018517504 |
|---|---|
| author | Dachuan Wang Haifeng Wang Wun-Jer Shen |
| author_facet | Dachuan Wang Haifeng Wang Wun-Jer Shen |
| author_sort | Dachuan Wang |
| collection | DOAJ |
| description | Intradural herniation of a cervical disc is rare; less than 35 cases have been reported to date. A 52-year-old man with preexisting ossification of posterior longitudinal ligament developed severe neck pain with Lt hemiparesis while asleep. Neurological exam was consistent with Brown-Séquard syndrome. Magnetic resonance images showed a C5-6 herniated disc that was adjacent to the ossified ligament and indenting the cord. The mass was surrounded by cerebrospinal fluid signal intensity margin, and caudally the ventral dura line appears divided into two, consistent with the “Y-sign” described by Sasaji et al. Cord edema were noted. Because of preexisting canal stenosis and spinal cord at risk, a laminoplasty was performed, followed by an anterior C6 corpectomy. Spot-weld type adhesions of the posterior longitudinal ligament to the dura was noted, along with a longitudinal tear in the dura. An intradural extra-arachnoid fragment of herniated disc was removed. Clinical exam at 6 months after surgery revealed normal muscle strength but persistent mild paresthesias. It is difficult to make a definite diagnosis of intradural herniation preoperatively; however, the clinical findings and radiographic signs mentioned above are suggestive and should alert the surgeon to look for an intradural fragment. |
| format | Article |
| id | doaj-art-5a05b591c7de4b81b92915cd140b79ec |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-5a05b591c7de4b81b92915cd140b79ec2025-02-03T01:12:17ZengWileyCase Reports in Orthopedics2090-67492090-67572014-01-01201410.1155/2014/256207256207Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal LigamentDachuan Wang0Haifeng Wang1Wun-Jer Shen2Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong 250021, ChinaDepartment of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong 250021, ChinaPo-Cheng Orthopaedic Institute, 100 Bo-Ai 2nd Road, Kaohsiung 81357, TaiwanIntradural herniation of a cervical disc is rare; less than 35 cases have been reported to date. A 52-year-old man with preexisting ossification of posterior longitudinal ligament developed severe neck pain with Lt hemiparesis while asleep. Neurological exam was consistent with Brown-Séquard syndrome. Magnetic resonance images showed a C5-6 herniated disc that was adjacent to the ossified ligament and indenting the cord. The mass was surrounded by cerebrospinal fluid signal intensity margin, and caudally the ventral dura line appears divided into two, consistent with the “Y-sign” described by Sasaji et al. Cord edema were noted. Because of preexisting canal stenosis and spinal cord at risk, a laminoplasty was performed, followed by an anterior C6 corpectomy. Spot-weld type adhesions of the posterior longitudinal ligament to the dura was noted, along with a longitudinal tear in the dura. An intradural extra-arachnoid fragment of herniated disc was removed. Clinical exam at 6 months after surgery revealed normal muscle strength but persistent mild paresthesias. It is difficult to make a definite diagnosis of intradural herniation preoperatively; however, the clinical findings and radiographic signs mentioned above are suggestive and should alert the surgeon to look for an intradural fragment.http://dx.doi.org/10.1155/2014/256207 |
| spellingShingle | Dachuan Wang Haifeng Wang Wun-Jer Shen Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament Case Reports in Orthopedics |
| title | Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament |
| title_full | Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament |
| title_fullStr | Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament |
| title_full_unstemmed | Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament |
| title_short | Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament |
| title_sort | spontaneous cervical intradural disc herniation associated with ossification of posterior longitudinal ligament |
| url | http://dx.doi.org/10.1155/2014/256207 |
| work_keys_str_mv | AT dachuanwang spontaneouscervicalintraduraldischerniationassociatedwithossificationofposteriorlongitudinalligament AT haifengwang spontaneouscervicalintraduraldischerniationassociatedwithossificationofposteriorlongitudinalligament AT wunjershen spontaneouscervicalintraduraldischerniationassociatedwithossificationofposteriorlongitudinalligament |