STUDY DESIGN: Case report and review of the literature. OBJECTIVE: To report two additional cases with intradural cervical herniation and review the pertinent literature. SUMMARY OF BACKGROUND DATA: Intradural cervical disc herniation is rare and a total of 22 cases were reported in 2007. In searching the world literature on this topic, we found 27 cases of intradural cervical disc herniation in all. METHODS: Clinical history, physical examination, and radiographic findings of two patients with intradural cervical disc herniation were described, and corpectomy was performed in both cases. A review of the literature was completed. RESULT: The outcome of one case was gratifying, and at a 36-month follow-up, nearly a full recovery was obtained. But the other's condition was disappointing, whose postoperative MRI demonstrated high signal intensity in the spinal cord and adhesion of spinal cord to the posterior margin at C4 level. CONCLUSION: Intradural cervical disc herniation is relatively rare, and the two additional cases updated the number of this condition to 29. It remains difficult to definitively diagnose the disease before surgery, but some indirect signs may indicate the cases. Corpectomy under a microscope as the first option in treatment of this disease is recommended once it is highly diagnosed. The pathogenesis of intradural cervical disc herniation remains to be further investigated. We presume that biochemical factors may play an important role in the pathogenesis.
STUDY DESIGN: Case report and review of the literature. OBJECTIVE: To report two additional cases with intradural cervical herniation and review the pertinent literature. SUMMARY OF BACKGROUND DATA: Intradural cervical disc herniation is rare and a total of 22 cases were reported in 2007. In searching the world literature on this topic, we found 27 cases of intradural cervical disc herniation in all. METHODS: Clinical history, physical examination, and radiographic findings of two patients with intradural cervical disc herniation were described, and corpectomy was performed in both cases. A review of the literature was completed. RESULT: The outcome of one case was gratifying, and at a 36-month follow-up, nearly a full recovery was obtained. But the other's condition was disappointing, whose postoperative MRI demonstrated high signal intensity in the spinal cord and adhesion of spinal cord to the posterior margin at C4 level. CONCLUSION: Intradural cervical disc herniation is relatively rare, and the two additional cases updated the number of this condition to 29. It remains difficult to definitively diagnose the disease before surgery, but some indirect signs may indicate the cases. Corpectomy under a microscope as the first option in treatment of this disease is recommended once it is highly diagnosed. The pathogenesis of intradural cervical disc herniation remains to be further investigated. We presume that biochemical factors may play an important role in the pathogenesis.
Authors: Christian Brogna; José Pedro Lavrador; Sabina Patel; Francesco Vergani; Sanjeev Bassi; Gordan Grahovac; Ranjeev Bhangoo; Keyoumars Ashkan Journal: Surg Neurol Int Date: 2018-06-18