Intervertebral disc herniation is common condition, with majority occurring in lumbar and cervical spine. Most lumbar disk herniations occur within the spinal canal, with approximately 7%-10% identified within the foramen or extraforaminal location. Extraforaminal disc herniation in extreme lateral, retroperitoneal or anterior terms are used when disc material is seen towards anterolateral or anterior to the spine. Disc herniation in these locations is easily mistaken for an abscess or a neoplasm especially when it is not connected to the parent disc (sequestered disc). We describe a case of 60-year male who initially was misdiagnosed as psoas abscess and subjected to invasive investigation which later turned out to be histologically confirmed disc sequestration in the retroperitoneum. Thus, knowledge of this condition is essential in avoiding unnecessary workup and treatment.
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http://dx.doi.org/10.1016/j.radcr.2021.10.024 | DOI Listing |
J Int Med Res
January 2025
Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, Hangzhou, China.
An 18-year-old female patient presented with a 1-month history of low back pain, which had worsened and was accompanied by radiating pain in the right lower limb for half a month. She was admitted to our hospital with computed tomography and magnetic resonance imaging findings suggesting calcification of the L3/4 disc and a large intraspinal mass at the L2-4 level. The patient's symptoms did not improve with conservative treatment, and her muscle strength rapidly declined.
View Article and Find Full Text PDFJ Can Chiropr Assoc
December 2024
Division of Neurosurgery, Université de Montréal.
Objective: This case report discusses the diagnostic challenges associated with the early identification of cauda equina syndrome in a 25-year-old patient without lumbar spinal pain. It introduces a new classification scheme related to a more effective diagnosis.
Clinical Features: The patient experienced pain in the right hamstring, diagnosed as a pulled muscle.
JBJS Case Connect
October 2024
Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Case: A 34-year-old man presented at our hospital with knee collapse. Magnetic resonance imaging (MRI) revealed posterior compression of the dural sac by a lumbar epidural lesion; however, a diagnosis could not be reached. Gadolinium (Gd)-enhanced 3-dimensional MRI (3D-MRI) clearly delineated the morphology, enabling us to make a preoperative diagnosis of posterior epidural migration of the lumbar disc fragment (PEMLDF).
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Spine Surgery, Binzhou Medical University Hospital, No. 661, Huanghe Er Road, Binzhou, 256603, Shandong, China.
Background: One-hole split endoscopy (OSE) is a novel endoscopic technique that offers some advantages in spinal surgery. However, without a clear understanding of the safe zone for OSE, surgeons risk injuring nerve roots during the procedure. This study aimed to measure the safe distances among critical bone markers, the intervertebral space and nerve roots between 1-degree degenerative lumbar spondylolisthesis (DLS) and non-DLS at the L segment in patients via three-dimensional reconstruction and to compare the differences in relevant safety distances between the two groups.
View Article and Find Full Text PDFEur Spine J
January 2025
Department of Traditional Chinese Medicine, Dongguan Binhaiwan Central Hospital, Dongguan City, Guangdong Province, 523905, China.
Objective: To explore the efficacy and safety of the direct inferior endplate approach in percutaneous endoscopic interlaminar discectomy (PEID) for the treatment of L5-S1 disc herniation.
Methods: This was a retrospective analysis of 116 patients with L5-S1 disc herniation treated with PEID; 74 patients underwent surgery via the direct inferior endplate approach (group A), and 42 patients underwent surgery via the indirect approach (group B). The number of intraoperative fluoroscopy exposures, establishment channel time, operation time, postoperative visual analogue scale (VAS) score, and Oswestry Disability Index (ODI) were compared between the 2 groups.
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