Sudden bilateral foot drop due to dorsally unilateral migration of the herniated lumbar disc: A case report

2021 ◽  
pp. 1-5
Author(s):  
Hoon Seok ◽  
Seung Yeol Lee ◽  
Dong Seong Shin ◽  
Jung Hoon Kang ◽  
Soo Bin Im ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Emergency Operation ◽  
Sudden Onset ◽  
Foot Drop ◽  
Leg Pain ◽  
Resonance Imaging ◽  
Dural Sac ◽  
Disc Material ◽  
Herniated Lumbar Disc ◽  
Extradural Space

BACKGROUND: Due to the anatomical characteristics of the anterior epidural space, dorsal migration of material from herniated lumbar disc is quite rare. Also, bilateral foot drop due to unilateral dorsal migration of disc herniation is extremely rare. This report presents a case of sudden bilateral foot drop caused by the unilateral dorsal migration of material from a herniated lumbar disc. CASE DESCRIPTION: A 51-year-old male presented with sudden onset severe leg pain with bilateral foot drop. The patient was referred to our emergency department by a local clinic. Neurological examination showed bilateral ankle and big toe dorsiflexion weakness grade 1. There was no perianal anesthesia, anal sphincter weaknesses, or voiding difficulty. Apart from essential hypertension, this patient’s medical history was unremarkable. Magnetic resonance imaging showed that intervertebral disc material in the dorsal extradural space at the L3-4 level had compressed the dural sac from the left side to the center. We performed an emergency operation. The pathologic result revealed fibrous cartilaginous materials. After the operation, the leg pain was markedly resolved. At postoperative three months, the patient showed improvement of foot drop. CONCLUSION: We recommended emergent mass removal, which produced a favorable outcome.

scholarly journals Early Postoperative Results after Removal of Cranially Migrated Lumbar Disc Prolapse: Retrospective Comparison of Three Different Surgical Strategies

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
C. Schulz ◽  
U. Kunz ◽  
U. M. Mauer ◽  
R. Mathieu
Keyword(s):  
Lumbar Disc ◽  
Leg Pain ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Retrospective Comparison ◽  
Interlaminar Approach ◽  
Disc Material ◽  
Disc Herniations ◽  
Group A ◽  
Group B

Background. To compare the early postoperative results of three surgical approaches to lumbar disc herniations that migrated cranially. Minimally invasive techniques such as the translaminar and endoscopic transforaminal approaches are utilized in patients with lumbar disc herniations to gain access to cranially located disc material and to avoid the potentially destabilizing resection of ligament and bone tissue, which is associated with an extended interlaminar approach.Methods. This retrospective study compares the postoperative pain and functional capacity levels of 69 patients who underwent an interlaminar (Group A,n=27), a translaminar (Group B,n=22), or an endoscopic transforaminal procedure (Group C,n=20).Results. Median VAS scores for leg pain decreased significantly from before to after surgery in all groups. Surgical revisions were required in thirteen cases (five in Group A, one in Group B, and seven in Group C;P=0.031). After six weeks, there were significant differences in back pain and functional outcome scores and in the results for the MacNab criteria but not in leg pain scores.Conclusions. The interlaminar and translaminar techniques were the safest and fastest ways of gaining access to cranially migrated disc material and the most effective approaches over a period of six weeks.

scholarly journals Dorsal extrusion of intervertebral disc as a cause of cauda equina syndrome

2011 ◽  
Vol 64 (7-8) ◽  
pp. 419-421
Author(s):  
Aldin Jusic ◽  
Rasim Skomorac ◽  
Hakija Beculic
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intervertebral Disc ◽  
Urinary Retention ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Good Recovery ◽  
Resonance Imaging ◽  
Extradural Space

We have presented a case of rare dorsally sequestrated lumbar disc herniation manifesting as cauda equina syndrome. The patient was admitted to the Neurological Department of Canton Hospital Zenica due to urinary retention and weakness in both lower extremities. Magnetic resonance imaging showed a compressing mass located in the dorsal extradural space at the L2- L3 level. An extruded intervertebral disc was found intraoperatively. The decompression was followed by good recovery.

scholarly journals Disappearing cervical disc

1996 ◽  
Vol 1 (6) ◽  
pp. E4 ◽  
Author(s):  
Richard M. Westmark ◽  
Kaye D. Westmark ◽  
Volker K. H. Sonntag
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Spontaneous Resolution ◽  
Herniated Disc ◽  
Cervical Disc ◽  
Resonance Imaging ◽  
Herniated Lumbar Disc

The authors report the case of a 48-year-old woman who experienced spontaneous resolution of a large herniated disc at C6-7. Spontaneous resolution of a herniated lumbar disc was first documented by computerized tomography. This case is another example of a rare spontaneous resolution of a cervical disc herniation documented by magnetic resonance imaging.

Microdiscectomy Improves Pain-Associated Depression, Somatic Anxiety, and Mental Well-Being in Patients With Herniated Lumbar Disc

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. 306-311 ◽  
Author(s):  
Richard Lebow ◽  
Scott L. Parker ◽  
Owoicho Adogwa ◽  
Adam Reig ◽  
Joseph Cheng ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Well Being ◽  
Leg Pain ◽  
Low Back ◽  
Analog Scale ◽  
Somatic Anxiety ◽  
Sf 36 ◽  
Herniated Lumbar Disc ◽  
Mental Well Being

Abstract BACKGROUND: Emotional distress and depression are common psychological disturbances associated with low-back and leg pain. The effects of lumbar discectomy on pain, disability, and physical quality of life are well described. The effects of discectomy on emotional distress and mental well-being are less well understood. OBJECTIVE: To assess the effect of microdiscectomy on depression, somatization, and mental well-being in patients with herniated lumbar discs. METHODS: Patients undergoing surgical discectomy for single-level, herniated lumbar disc were prospectively evaluated preoperatively, and at 6 weeks and 3, 6, and 12 months postoperatively. Back and leg pain, depression, somatic perception, and mental well-being were assessed. RESULTS: One hundred patients were enrolled. All were available for 1-year follow-up. Preoperatively, the visual analog scale for low-back pain (BP-VAS), visual analog scale for leg pain (LP-VAS), Zung Self-Rating Depression Scale (ZUNG), Modified Somatic Perception Questionnaire (MSPQ), and Medical Outcomes Short Form-36 mental component summary scale (SF-36-MCS) were 6.3 ± 2.5, 6.3 ± 2.5, 19 ± 11, 9 ± 7, and 4 ± 14. BP-VAS and LP-VAS significantly improved by 6 weeks. Significant improvement in SF-36-MCS was observed by 6 weeks postoperatively, improvement in MSPQ score was observed 3 months postoperatively, and improvement in the ZUNG depression score was observed 12 months postoperatively. No statistical difference occurred during the remainder of follow-up for any outcome measured once improvement reached statistical significance. Eighteen patients were somatized preoperatively, 67% of which were nonsomatized 1 year postoperatively. Ten patients were clinically depressed preoperatively, 70% of which were nondepressed 1 year postoperatively. Improvement in SF-36-MCS, ZUNG, and MSPQ correlated (P < .001) with improvement in BP-VAS and LP-VAS. CONCLUSION: The majority of patients somatized or depressed preoperatively returned to good mental well-being postoperatively. Improvement in pain and overall mental well-being was seen immediately after discectomy. Improvement in somatic anxiety and depression occurred months later. Microdiscectomy significantly improves pain-associated depression, somatic anxiety, and mental well-being in patients with herniated lumbar disc.

scholarly journals Alternative strategies for lumbar discectomy: intradiscal electrothermy and nucleoplasty

2002 ◽  
Vol 13 (2) ◽  
pp. 1-6 ◽  
Author(s):  
William C. Welch ◽  
Peter C. Gerszten
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Disc ◽  
Lessons Learned ◽  
Leg Pain ◽  
Low Back ◽  
Disc Disease ◽  
Discogenic Pain ◽  
Discogenic Low Back Pain ◽  
Disc Material

In recent years the general trend in spinal surgery has been one of reductionism and minimalization. A number of techniques have recently been developed that are applicable in the treatment of lumbar disc herniation and discogenic pain due to degenerative disc disease. The purpose of this manuscript is to examine two newer percutaneous disc treatment techniques, intradiscal electrothermal therapy (IDET) anuloplasty and nucleoplasty. The authors review the appropriate clinical treatment criteria, techniques, and lessons learned after performing these procedures in more than 100 patients. The IDET involves the percutaneous insertion of a specially designed thermal resistance probe followed by controlled heating of the intervertebral disc. This may result in disc shrinkage and reduction in pain. The nucleoplasty procedure involves the percutaneous removal of disc material by using a low-temperature resister probe to disintegrate and evacuate disc material, followed by thermal treatment of adjacent residual disc material. To date, no study has been published in which investigators examine the outcomes of this procedure for the treatment of radicular leg pain and low-back pain. Both IDET and nucleoplasty appear to be safe procedures. The IDET procedure may be an alternative to lumbar interbody fusion. Although its long-term role is being defined, this technique appears to provide intermediate-term relief of pain in a population of patients with discogenic low-back pain. Nucleoplasty may provide a percutaneous alternative to microdiscectomy in selected cases.

Unilateral surgical approach for lumbar disc herniation with contralateral symptoms

2012 ◽  
Vol 17 (2) ◽  
pp. 124-127 ◽  
Author(s):  
Taşkan Akdeniz ◽  
Tuncay Kaner ◽  
İbrahim Tutkan ◽  
Ali Fahir Ozer
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Surgical Approach ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Leg Pain ◽  
Motor Deficits ◽  
Disc Herniations ◽  
Herniated Lumbar Disc ◽  
Contralateral Symptoms

Object In most cases of lumbar disc herniation, the primary problem is usually limited to radicular pain due to nerve compression on the herniated side, which is generally limited to the side of operation. The aim of this study was to reevaluate the side of the surgical approach in a selected group of patients with leg pain and contralateral lumbar disc herniation. Methods Included in this study were a total of 5 patients with lumbar disc herniations who presented with contralateral symptoms and neurological signs. In all cases, patients underwent a microdiscectomy from the side ipsilateral to the herniated lumbar disc, the side contralateral to the motor deficits and leg pain. Results The symptoms and signs, to some extent, resolved during the immediate postoperative period. There were no postoperative complications. Conclusions The findings confirm that performing a laminotomy via the side of the herniation is sufficient for this group of patients.

Disappearing cervical disc

1997 ◽  
Vol 86 (2) ◽  
pp. 289-290 ◽  
Author(s):  
Richard M. Westmark ◽  
Kaye D. Westmark ◽  
Volker K. H. Sonntag
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lumbar Disc ◽  
Spontaneous Resolution ◽  
Herniated Disc ◽  
Cervical Disc ◽  
Resonance Imaging ◽  
Content Type ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ The authors report the case of a 48-year-old woman who experienced spontaneous resolution of a large herniated disc at C6–7. Spontaneous resolution of a herniated lumbar disc was first documented by computerized tomography. This case is another example of a rare spontaneous resolution of a cervical disc herniation documented by magnetic resonance imaging.

Dumbbell Ganglioneuroma of the Lumbar Spine Associated with a Herniated Intervertebral Disc: Case Report

Neurosurgery ◽  
1983 ◽  
Vol 13 (6) ◽  
pp. 711-714 ◽  
Author(s):  
John James Oro ◽  
August William Geise
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Surgical Approach ◽  
Lumbar Disc ◽  
Sympathetic Ganglia ◽  
Radiographic Analysis ◽  
Herniated Lumbar Disc ◽  
Extradural Space ◽  
Herniated Intervertebral Disc

Abstract Paraspinal ganglioneuromas with extension into the spinal extradural space are rare tumors. Their management usually requires cooperation with surgeons of other specialties. The authors describe a case of a dumbbell ganglioneuroma arising from the lumbar sympathetic ganglia in a patient presenting with a herniated lumbar disc. The clinical features, radiographic analysis, and surgical approach to these tumors are briefly discussed.

scholarly journals Bilateral leg pain and unilateral calf atrophy caused by polymyositis accompanying lumbar spinal stenosis and disc herniation: a case report

2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110694
Author(s):  
In-Hwa Baek ◽  
Hyung-Youl Park ◽  
Ho-Young Jung ◽  
Jun-Seok Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Resonance Imaging ◽  
Muscle Enzyme ◽  
Lumbar Spinal ◽  
Calf Pain

Polymyositis is a subgroup of idiopathic inflammatory myopathies characterized by symmetric proximal limb weakness and chronic skeletal muscle inflammation. We herein report the first case of bilateral leg pain and unilateral calf atrophy caused by polymyositis accompanying lumbar spinal stenosis and disc herniation. A 52-year-old man presented with intermittent claudication and calf pain that had become gradually aggravated during the last 3 months. Magnetic resonance imaging showed spinal stenosis at the L3/4 and L4/5 levels and lumbar disc herniation at the L4/5 level. Preoperative laboratory investigations revealed elevated muscle enzyme concentrations. Magnetic resonance imaging also showed atrophy, fatty degeneration, and edema in both calf muscles. Histological examination showed inflammatory myositis and fibrosis in the perifascicular connective tissues. The patient was diagnosed with polymyositis. We performed decompressive laminectomy at the L3/4 and L4/5 levels and discectomy at the L4/5 level. After administration of prednisolone for 6 months and methotrexate for 3 months, the patient’s bilateral calf pain and abnormal laboratory findings improved. The combination of surgical decompression and adequate medical treatment resulted in a successful recovery. Polymyositis should be suspected in patients with lumbar spinal stenosis or lumbar disc herniation who exhibit increased muscle enzyme concentrations or lower extremity muscle atrophy.

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