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Migrated Disc at Cervicothoracic Junction Presenting as Acute Paraplegia.

Mahore A, Agarwal M, Ramdasi R, Tikeykar V - Asian Spine J (2015)

Bottom Line: Herein, we report on an inferior migration of an intervertebral disc C6-7 to the cervicothoracic junction manifesting as acute paraplegia.The patient showed a remarkable recovery after the surgery.The diagnostic dilemma and management difficulties of such an entity are briefly discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India.

ABSTRACT
Herein, we report on an inferior migration of an intervertebral disc C6-7 to the cervicothoracic junction manifesting as acute paraplegia. The patient showed a remarkable recovery after the surgery. The diagnostic dilemma and management difficulties of such an entity are briefly discussed.

No MeSH data available.


Related in: MedlinePlus

(A) Photomicrograph (H&E, ×40) showing degenerated nucleus pulposus composed of irregualar fibrillar matrix. (B) Photomicrograph (H&E, ×40) showing calcification of the cartilage cells and the surrounding matrix.
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Figure 2: (A) Photomicrograph (H&E, ×40) showing degenerated nucleus pulposus composed of irregualar fibrillar matrix. (B) Photomicrograph (H&E, ×40) showing calcification of the cartilage cells and the surrounding matrix.

Mentions: A 70-year-old smoker was admitted with acute onset severe interscapular pain and paraplegia following a bout of cough. The patient was on treatment for coronary artery disease. The clinical examination revealed spatic paraplegia, weak grips with relatively preserved proprioception and sense of vibration. A provisional diagnosis of aortic dissection was made by the emergency physician, but an aortic angiography failed to show any abnormality. The magnetic resonance imaging (MRI) of the spine revealed a midline ventral epidural lesion at C7-T1 level, isointense to cord in both T1 and T2 (Fig. 1A-C). C7-T1 disc space and posterior longitudinal ligament were observed as undisturbed. However, the height of the C6-7 disc was significantly lesser than normal (Fig. 1D) with minimal disc material lying behind the C7 vertebral body suggestive of a migrated C6-7 disc (Fig. 1B). During operation, the lesion was located in the epidural space of C7-T1. The operation was done using the anterior approach through the C7-T1 disc space. The annulus fibrosus and the posterior longitudinal ligament behind the C7-T1 disc was intact. The diagnosis of the disc material was histologically confirmed (Fig. 2). The patient showed a dramatic and progressive recovery in postoperative period. At 2 years follow-up, the patient had a normal neurological status.


Migrated Disc at Cervicothoracic Junction Presenting as Acute Paraplegia.

Mahore A, Agarwal M, Ramdasi R, Tikeykar V - Asian Spine J (2015)

(A) Photomicrograph (H&E, ×40) showing degenerated nucleus pulposus composed of irregualar fibrillar matrix. (B) Photomicrograph (H&E, ×40) showing calcification of the cartilage cells and the surrounding matrix.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4472595&req=5

Figure 2: (A) Photomicrograph (H&E, ×40) showing degenerated nucleus pulposus composed of irregualar fibrillar matrix. (B) Photomicrograph (H&E, ×40) showing calcification of the cartilage cells and the surrounding matrix.
Mentions: A 70-year-old smoker was admitted with acute onset severe interscapular pain and paraplegia following a bout of cough. The patient was on treatment for coronary artery disease. The clinical examination revealed spatic paraplegia, weak grips with relatively preserved proprioception and sense of vibration. A provisional diagnosis of aortic dissection was made by the emergency physician, but an aortic angiography failed to show any abnormality. The magnetic resonance imaging (MRI) of the spine revealed a midline ventral epidural lesion at C7-T1 level, isointense to cord in both T1 and T2 (Fig. 1A-C). C7-T1 disc space and posterior longitudinal ligament were observed as undisturbed. However, the height of the C6-7 disc was significantly lesser than normal (Fig. 1D) with minimal disc material lying behind the C7 vertebral body suggestive of a migrated C6-7 disc (Fig. 1B). During operation, the lesion was located in the epidural space of C7-T1. The operation was done using the anterior approach through the C7-T1 disc space. The annulus fibrosus and the posterior longitudinal ligament behind the C7-T1 disc was intact. The diagnosis of the disc material was histologically confirmed (Fig. 2). The patient showed a dramatic and progressive recovery in postoperative period. At 2 years follow-up, the patient had a normal neurological status.

Bottom Line: Herein, we report on an inferior migration of an intervertebral disc C6-7 to the cervicothoracic junction manifesting as acute paraplegia.The patient showed a remarkable recovery after the surgery.The diagnostic dilemma and management difficulties of such an entity are briefly discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India.

ABSTRACT
Herein, we report on an inferior migration of an intervertebral disc C6-7 to the cervicothoracic junction manifesting as acute paraplegia. The patient showed a remarkable recovery after the surgery. The diagnostic dilemma and management difficulties of such an entity are briefly discussed.

No MeSH data available.


Related in: MedlinePlus