Intradural thoracic disc herniation. 1994

J L Stone, and T Lichtor, and S Banerjee
Division of Neurosurgery, Cook County Hospital, Chicago, Illinois.

METHODS Patients with intradural herniation of an intervertebral disc were identified and managed surgically. OBJECTIVE Illustrative cases of patients with intradural herniated discs at the mid-thoracic level are presented, the literature is reviewed, and the management of these patients is discussed. BACKGROUND Intradural herniation of an intervertebral disc is rare and most common at the lumbar level, but isolated cases have been reported at other levels. Cases reports of this entity have been published, but the surgical details have not been adequately addressed. METHODS In this report, two patients with calcified intradural herniated discs at the mid-thoracic level are presented. RESULTS Both patients had progressive paraparesis and had calcified disc material in the mid-thoracic canal. Both were treated successfully with a posterolateral extracavitary costotransversectomy and hemilaminotomy using intraoperative ultrasound and somatosensory-evoked potential monitoring. CONCLUSIONS This entity should be suspected when a calcified disc within the spinal canal is being treated. The optimal exposure is a posterolateral extracavitary costotransversectomy with a hemilaminotomy. Alternative approaches to a typical thoracic disc would be problematic in managing these patients.

UI MeSH Term Description Entries
D007405 Intervertebral Disc Displacement An INTERVERTEBRAL DISC in which the NUCLEUS PULPOSUS has protruded through surrounding ANNULUS FIBROSUS. This occurs most frequently in the lower lumbar region. Disc Herniation,Disc Protrusion,Disc, Herniated,Disk Herniation,Disk Protrusion,Disk, Herniated,Intervertebral Disc Herniation,Intervertebral Disc Protrusion,Intervertebral Disk Displacement,Intervertebral Disk Herniation,Intervertebral Disk Protrusion,Prolapsed Disk,Protruded Disc,Protruded Disk,Slipped Disk,Disk Prolapse,Herniated Disc,Herniated Disk,Prolapsed Disc,Slipped Disc,Disc Displacement, Intervertebral,Disc Herniations,Disc Protrusion, Intervertebral,Disc Protrusions,Disc Protrusions, Intervertebral,Disc, Prolapsed,Disc, Protruded,Disc, Slipped,Discs, Protruded,Disk Displacement, Intervertebral,Disk Herniations,Disk Prolapses,Disk Protrusion, Intervertebral,Disk Protrusions,Disk, Prolapsed,Disk, Protruded,Disk, Slipped,Herniated Discs,Herniated Disks,Herniation, Disc,Herniation, Disk,Herniation, Intervertebral Disc,Herniation, Intervertebral Disk,Intervertebral Disc Displacements,Intervertebral Disc Herniations,Intervertebral Disc Protrusions,Intervertebral Disk Displacements,Intervertebral Disk Herniations,Intervertebral Disk Protrusions,Prolapse, Disk,Prolapsed Discs,Prolapsed Disks,Prolapses, Disk,Protruded Discs,Protruded Disks,Protrusion, Disc,Protrusion, Disk,Protrusion, Intervertebral Disc,Protrusion, Intervertebral Disk,Protrusions, Intervertebral Disk,Slipped Discs,Slipped Disks
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010264 Paraplegia Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness. Paralysis, Lower Extremities,Paraplegia, Spastic,Spastic Paraplegia,Paralysis, Legs,Paralysis, Lower Limbs,Paraplegia, Ataxic,Paraplegia, Cerebral,Paraplegia, Flaccid,Paraplegia, Spinal,Ataxic Paraplegia,Ataxic Paraplegias,Cerebral Paraplegia,Cerebral Paraplegias,Flaccid Paraplegia,Flaccid Paraplegias,Paraplegias,Paraplegias, Ataxic,Paraplegias, Cerebral,Paraplegias, Flaccid,Paraplegias, Spastic,Paraplegias, Spinal,Spastic Paraplegias,Spinal Paraplegia,Spinal Paraplegias
D004388 Dura Mater The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord. Falx Cerebelli,Falx Cerebri,Pachymeninx,Tentorium Cerebelli
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013117 Spinal Cord Compression Acute and chronic conditions characterized by external mechanical compression of the SPINAL CORD due to extramedullary neoplasm; EPIDURAL ABSCESS; SPINAL FRACTURES; bony deformities of the vertebral bodies; and other conditions. Clinical manifestations vary with the anatomic site of the lesion and may include localized pain, weakness, sensory loss, incontinence, and impotence. Conus Medullaris Syndrome,Myelopathy, Compressive,Extramedullary Spinal Cord Compression,Spinal Cord Compression, Extramedullary,Compression, Spinal Cord,Compressions, Spinal Cord,Compressive Myelopathy,Conus Medullaris Syndromes,Spinal Cord Compressions,Syndrome, Conus Medullaris,Syndromes, Conus Medullaris
D013904 Thoracic Vertebrae A group of twelve VERTEBRAE connected to the ribs that support the upper trunk region. Vertebrae, Thoracic

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