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Cervical intradural disc herniation.
Spine (Phila Pa 1976). 2001 Mar 15; 26(6):698-702.S

Abstract

STUDY DESIGN

A case report of anterior en bloc resected cervical intradural disc herniation and a review of the literature.

OBJECTIVE

To discuss the pathogenesis of cervical intradural disc herniation.

SUMMARY OF BACKGROUND DATA

Including this study case, only 17 cases of cervical intradural disc herniation have been reported. There have been few detailed reports concerning the pathogenesis of cervical intradural disc herniation.

METHODS

A cervical intradural disc herniation at C6-C7, with localized hypertrophy and segmentally ossified posterior longitudinal ligament, is reported in a 45-year-old man who had Brown-Sequard syndrome diagnosed on neurologic examination. Neuroradiologic, operative, and histologic findings, particularly the pathology of the anterior en bloc resected posterior vertebral portion of C6 and C7, were evaluated for discussion of the pathogenesis.

RESULTS

Adhesion of dura mater and hypertrophic posterior longitudinal ligament was observed around a perforated portion of the herniated disc, and histologic study showed irregularity in fiber alignment accompanied by scattered inflammatory cell infiltration and hypertrophy in the posterior longitudinal ligament. The cervical intradural disc herniation was removed successfully and followed by C5-Th1 anterior interbody fusion with fibular strut graft. Neurologic recovery was complete except for minor residual sensory disturbance in the leg 7 years after the surgery.

CONCLUSIONS

Cervical intradural disc herniation is an extremely rare condition. The pathogenesis remains obscure. Only 16 cases have been reported in the literature, and there has been little discussion concerning the local pathology of the herniated portion. The pathogenesis of the disease in the patient reported here was considered to be the adhesion and fragility of dura mater and posterior longitudinal ligament. This was caused by hypertrophy, with chronic inflammation and ossification of the posterior longitudinal ligament sustaining chronic mechanical irritation to the dura mater, leading to perforation of the herniated disc by an accidental force.

Authors+Show Affiliations

Department of Orthopedic Surgery, Yokohama Ekisaikai Hospital, Kanagawa, Japan. gan-chan@onyx.dti.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11246389

Citation

Iwamura, Y, et al. "Cervical Intradural Disc Herniation." Spine, vol. 26, no. 6, 2001, pp. 698-702.
Iwamura Y, Onari K, Kondo S, et al. Cervical intradural disc herniation. Spine. 2001;26(6):698-702.
Iwamura, Y., Onari, K., Kondo, S., Inasaka, R., & Horii, H. (2001). Cervical intradural disc herniation. Spine, 26(6), 698-702.
Iwamura Y, et al. Cervical Intradural Disc Herniation. Spine. 2001 Mar 15;26(6):698-702. PubMed PMID: 11246389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cervical intradural disc herniation. AU - Iwamura,Y, AU - Onari,K, AU - Kondo,S, AU - Inasaka,R, AU - Horii,H, PY - 2001/3/14/pubmed PY - 2001/5/25/medline PY - 2001/3/14/entrez SP - 698 EP - 702 JF - Spine JO - Spine VL - 26 IS - 6 N2 - STUDY DESIGN: A case report of anterior en bloc resected cervical intradural disc herniation and a review of the literature. OBJECTIVE: To discuss the pathogenesis of cervical intradural disc herniation. SUMMARY OF BACKGROUND DATA: Including this study case, only 17 cases of cervical intradural disc herniation have been reported. There have been few detailed reports concerning the pathogenesis of cervical intradural disc herniation. METHODS: A cervical intradural disc herniation at C6-C7, with localized hypertrophy and segmentally ossified posterior longitudinal ligament, is reported in a 45-year-old man who had Brown-Sequard syndrome diagnosed on neurologic examination. Neuroradiologic, operative, and histologic findings, particularly the pathology of the anterior en bloc resected posterior vertebral portion of C6 and C7, were evaluated for discussion of the pathogenesis. RESULTS: Adhesion of dura mater and hypertrophic posterior longitudinal ligament was observed around a perforated portion of the herniated disc, and histologic study showed irregularity in fiber alignment accompanied by scattered inflammatory cell infiltration and hypertrophy in the posterior longitudinal ligament. The cervical intradural disc herniation was removed successfully and followed by C5-Th1 anterior interbody fusion with fibular strut graft. Neurologic recovery was complete except for minor residual sensory disturbance in the leg 7 years after the surgery. CONCLUSIONS: Cervical intradural disc herniation is an extremely rare condition. The pathogenesis remains obscure. Only 16 cases have been reported in the literature, and there has been little discussion concerning the local pathology of the herniated portion. The pathogenesis of the disease in the patient reported here was considered to be the adhesion and fragility of dura mater and posterior longitudinal ligament. This was caused by hypertrophy, with chronic inflammation and ossification of the posterior longitudinal ligament sustaining chronic mechanical irritation to the dura mater, leading to perforation of the herniated disc by an accidental force. SN - 0362-2436 UR - https://www.unboundmedicine.com/medline/citation/11246389/Cervical_intradural_disc_herniation_ L2 - http://dx.doi.org/10.1097/00007632-200103150-00029 DB - PRIME DP - Unbound Medicine ER -