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A rare case of concomitant cervical disc herniation and intradural meningioma treated with one-stage posterior surgery.
Eur Spine J. 2018 07; 27(Suppl 3):426-430.ES

Abstract

STUDY DESIGN

Case report.

PURPOSE

To present a rare case of cervical disc herniation concomitant with intradural meningioma which was successfully treated using a single one-stage posterior surgery of tumor resection and transdural discectomy. Coexistence of symptomatic disc herniation and intra-spinal tumor in the same cervical segment is extremely rare. Usually, two-stage anterior and posterior surgeries are needed to treat two conditions, respectively. One-stage posterior surgery to treat two pathologies simultaneously has not been reported in the literature.

METHODS AND RESULTS

A 76-year-old man presented with leg weakness and numbness for 6 months and left arm pain for 2 months. Contrast MR imaging revealed C3/4 intervertebral disc herniation and a hyperintense intradural lesion at the right portion of C3 canal. A one-stage posterior surgery, including C3/4 laminectomy, intradural tumor resection, transdural C3/4 discectomy, and C3/4 lateral mass instrumentation and fusion, was performed to treat two distinct pathologies together. The patient's arm pain and numbness disappeared right after the surgery and symptoms of myelopathy fully recovered at 6-month follow-up. Histological studies confirmed a herniated disc and a meningioma.

CONCLUSION

In rare case, intradural tumor coexists with cervical disc herniation. When suspicious findings were noticed, or clinical symptoms cannot be fully explained, contrast MR imaging is helpful in differential diagnosis. Microscopic transdural discectomy is safe, and could be used as an optional procedure for cervical disc herniation in some cases.

Authors+Show Affiliations

Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, People's Republic of China.Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, People's Republic of China.Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, People's Republic of China. wangyuespine@zju.edu.cn.

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29242976

Citation

Hu, Xiaojian, et al. "A Rare Case of Concomitant Cervical Disc Herniation and Intradural Meningioma Treated With One-stage Posterior Surgery." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 27, no. Suppl 3, 2018, pp. 426-430.
Hu X, Chen Z, Wang Y. A rare case of concomitant cervical disc herniation and intradural meningioma treated with one-stage posterior surgery. Eur Spine J. 2018;27(Suppl 3):426-430.
Hu, X., Chen, Z., & Wang, Y. (2018). A rare case of concomitant cervical disc herniation and intradural meningioma treated with one-stage posterior surgery. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 27(Suppl 3), 426-430. https://doi.org/10.1007/s00586-017-5414-y
Hu X, Chen Z, Wang Y. A Rare Case of Concomitant Cervical Disc Herniation and Intradural Meningioma Treated With One-stage Posterior Surgery. Eur Spine J. 2018;27(Suppl 3):426-430. PubMed PMID: 29242976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A rare case of concomitant cervical disc herniation and intradural meningioma treated with one-stage posterior surgery. AU - Hu,Xiaojian, AU - Chen,Zhong, AU - Wang,Yue, Y1 - 2017/12/14/ PY - 2017/09/23/received PY - 2017/10/27/accepted PY - 2017/12/16/pubmed PY - 2019/3/21/medline PY - 2017/12/16/entrez KW - Cervical disc herniation KW - Intradural meningioma KW - Spinal tumor KW - Transdural discectomy SP - 426 EP - 430 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 27 IS - Suppl 3 N2 - STUDY DESIGN: Case report. PURPOSE: To present a rare case of cervical disc herniation concomitant with intradural meningioma which was successfully treated using a single one-stage posterior surgery of tumor resection and transdural discectomy. Coexistence of symptomatic disc herniation and intra-spinal tumor in the same cervical segment is extremely rare. Usually, two-stage anterior and posterior surgeries are needed to treat two conditions, respectively. One-stage posterior surgery to treat two pathologies simultaneously has not been reported in the literature. METHODS AND RESULTS: A 76-year-old man presented with leg weakness and numbness for 6 months and left arm pain for 2 months. Contrast MR imaging revealed C3/4 intervertebral disc herniation and a hyperintense intradural lesion at the right portion of C3 canal. A one-stage posterior surgery, including C3/4 laminectomy, intradural tumor resection, transdural C3/4 discectomy, and C3/4 lateral mass instrumentation and fusion, was performed to treat two distinct pathologies together. The patient's arm pain and numbness disappeared right after the surgery and symptoms of myelopathy fully recovered at 6-month follow-up. Histological studies confirmed a herniated disc and a meningioma. CONCLUSION: In rare case, intradural tumor coexists with cervical disc herniation. When suspicious findings were noticed, or clinical symptoms cannot be fully explained, contrast MR imaging is helpful in differential diagnosis. Microscopic transdural discectomy is safe, and could be used as an optional procedure for cervical disc herniation in some cases. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/29242976/A_rare_case_of_concomitant_cervical_disc_herniation_and_intradural_meningioma_treated_with_one_stage_posterior_surgery_ L2 - https://doi.org/10.1007/s00586-017-5414-y DB - PRIME DP - Unbound Medicine ER -