Advanced Search

Home > Journals > Chirurgia > Past Issues > Chirurgia 2016 August;29(4) > Chirurgia 2016 August;29(4):140-2

ISSUES AND ARTICLES   MOST READ

CURRENT ISSUECHIRURGIA

A Journal on Surgery

Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index

Frequency: Bi-Monthly

ISSN 0394-9508

Online ISSN 1827-1782

 

Chirurgia 2016 August;29(4):140-2

    CASE REPORTS

Thoracic “soft” disk herniation producing sudden paraplegia in an adult patient

Rodolfo MADURI 1, Daniele STARNONI 1, Lukas BOBINSKI 1, 2, John M. DUFF 1, 3

1 Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital of Lausanne, Lausanne, Switzerland; 2 Spine Unit, Department of Orthopedic Surgery, University Hospital of Uppsala, Uppsala, Sweden; 3 Faculty of Biology and Medicine, Lausanne, Switzerland

Sudden paraplegia due to thoracic disk herniation without any previous symptoms has been episodically described in adult patients and surgical outcome is generally good. This report describes a case of thoracic “soft” disc herniation with acute flaccid paraplegia in an adult patient. A 58-year-old male presented with acute spontaneous paraparesis leading to paraplegia with sensory level at T12. Voluntary anal contraction was absent (Nurick Grade V). There was no history of preceding trauma. Thoraco-lumbar MRI showed a large T10-T11 left paracentral disc herniation compressing the spinal cord. The patient underwent emergency surgical decompression. There was no clinical improvement in the immediate postoperative period. After twelve months of follow up, the patient presented slight improvement of muscle strength in the right leg (Nurick Grade IV). There was no recovery of voluntary anal sphincter contraction. TDH accounts for less than 1% of symptomatic spinal disc herniation. Approximately 4% of “hard” consistency TDH presents with acute myelopathy mostly in pediatric patients. Here, we report a rare case of sudden onset flaccid paraplegia due to soft T10-T11 centrolateral disc herniation without improvement of neurologic conditions despite urgent decompressive surgery.

language: English


FULL TEXT  REPRINTS

top of page