Traumatic lumbar disc herniation: A systemic case review and meta-analysis.

Brain Spine

Spine Center for Neuroorthopaedics, Spinal Cord Injuries, and Scoliosis, RKH Orthopedic Clinic Markgröningen, Markgröningen, Germany.

Published: August 2023

Introduction: Traumatic lumbar disc herniation (TLDH) without fracture in the motion segment is a rare occurrence compared with degenerative herniation.

Research Question: This study provides a systematic discussion of various aspects related to the diagnosis of TLDH.

Material And Methods: This review includes 12 cases of TLDH with MR-images since 2009 published in the PubMed and one adjunct illustration. The cases were categorized into two groups for a comprehensive analysis, TLDH with or without segment fracture. Additionally, we reported a case of a 43-year-old female patient with a recent stenosing TLDH at L5/S1, accompanied by a large sequestration (disc herniation stage-4, and Michigan State University Classification: MSU 3-AB) and an endplate compression fracture at L2 (AO A1).

Results: Isolated traumatic lumbar disc herniation is possible, but it is required exclude cases with fractures in the motion segment.

Discussion And Conclusion: Trauma with related injury mechanisms is the highest priority for the diagnosis of TLDH. Low-grade disc degeneration without significant instability could be accepted for diagnosing TLDH. A TLDH on MR images might show a slightly lower T2-signal compared to the CSF and a homogeneous T1-signal like the spinal cord, as well as a similar STIR-signal of the sequestration and CSF. If necessary, a histological examination could be performed to evaluate the degenerative changes in the injured disc, especially to assist the evaluation due to legal reasons.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668050PMC
http://dx.doi.org/10.1016/j.bas.2023.102350DOI Listing

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