Two Cases of Iatrogenic Lumbar Foraminal Disc Herniations

Study Design. A case report. Objective. We report two cases of iatrogenic deterioration of lumbar foraminal disc herniations following lumbar disc injections. Summary of Background Data. Complications associated with discography were reported. However, only a few reports have thus far referred to th...

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Main Authors: Ryota Taniguchi, Osamu Kawano, Takeshi Maeda, Yasuharu Nakajima, Yuichiro Morishita
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2021/5546530
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author Ryota Taniguchi
Osamu Kawano
Takeshi Maeda
Yasuharu Nakajima
Yuichiro Morishita
author_facet Ryota Taniguchi
Osamu Kawano
Takeshi Maeda
Yasuharu Nakajima
Yuichiro Morishita
author_sort Ryota Taniguchi
collection DOAJ
description Study Design. A case report. Objective. We report two cases of iatrogenic deterioration of lumbar foraminal disc herniations following lumbar disc injections. Summary of Background Data. Complications associated with discography were reported. However, only a few reports have thus far referred to the iatrogenic deterioration of lumbar foraminal disc herniations. Cases. 60-year-old and 74-year-old men were treated with MR images of L4-5 foraminal disc herniations without fragment in the spinal canal. The patients underwent discography and disc block for its diagnosis and treatment. After disc injections, both patients complained of deterioration of L4 radiculopathy. Results. On disco-CT or reexamined MR images after disc injections, herniated fragment was migrated from neural foramen to cranial central spinal canal with was not shown in previous MR images. The herniated fragments were extirpated by means of osteoplastic laminoplasty or transforaminal lumbar interbody fusion with facetectomy. The herniated fragments were migrated from neural foramen to cranial central spinal canal. Conclusions. The injection of liquid medicine into the nucleus led the intradiscal pressure increased, and the disc fragment might prolapsed through the raptured region of annulus fibrosus and migrated to cranial central spinal canal by anatomical reason. The disc injection may have a risk for deterioration of foraminal disc herniation. Our report is instructive for the management of discography for the diagnosis of foraminal disc herniations.
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spelling doaj-art-a309c44aae8146d69f9316412b6439fe2025-02-03T01:33:19ZengWileyCase Reports in Orthopedics2090-67572021-01-01202110.1155/2021/5546530Two Cases of Iatrogenic Lumbar Foraminal Disc HerniationsRyota Taniguchi0Osamu Kawano1Takeshi Maeda2Yasuharu Nakajima3Yuichiro Morishita4Department of Orthopedic SurgeryDepartment of Orthopedic SurgeryDepartment of Orthopedic SurgeryDepartment of Orthopedic SurgeryDepartment of Orthopedic SurgeryStudy Design. A case report. Objective. We report two cases of iatrogenic deterioration of lumbar foraminal disc herniations following lumbar disc injections. Summary of Background Data. Complications associated with discography were reported. However, only a few reports have thus far referred to the iatrogenic deterioration of lumbar foraminal disc herniations. Cases. 60-year-old and 74-year-old men were treated with MR images of L4-5 foraminal disc herniations without fragment in the spinal canal. The patients underwent discography and disc block for its diagnosis and treatment. After disc injections, both patients complained of deterioration of L4 radiculopathy. Results. On disco-CT or reexamined MR images after disc injections, herniated fragment was migrated from neural foramen to cranial central spinal canal with was not shown in previous MR images. The herniated fragments were extirpated by means of osteoplastic laminoplasty or transforaminal lumbar interbody fusion with facetectomy. The herniated fragments were migrated from neural foramen to cranial central spinal canal. Conclusions. The injection of liquid medicine into the nucleus led the intradiscal pressure increased, and the disc fragment might prolapsed through the raptured region of annulus fibrosus and migrated to cranial central spinal canal by anatomical reason. The disc injection may have a risk for deterioration of foraminal disc herniation. Our report is instructive for the management of discography for the diagnosis of foraminal disc herniations.http://dx.doi.org/10.1155/2021/5546530
spellingShingle Ryota Taniguchi
Osamu Kawano
Takeshi Maeda
Yasuharu Nakajima
Yuichiro Morishita
Two Cases of Iatrogenic Lumbar Foraminal Disc Herniations
Case Reports in Orthopedics
title Two Cases of Iatrogenic Lumbar Foraminal Disc Herniations
title_full Two Cases of Iatrogenic Lumbar Foraminal Disc Herniations
title_fullStr Two Cases of Iatrogenic Lumbar Foraminal Disc Herniations
title_full_unstemmed Two Cases of Iatrogenic Lumbar Foraminal Disc Herniations
title_short Two Cases of Iatrogenic Lumbar Foraminal Disc Herniations
title_sort two cases of iatrogenic lumbar foraminal disc herniations
url http://dx.doi.org/10.1155/2021/5546530
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