Spontaneous resorption in recurrent intradural lumbar disc herniation. Case report.
The authors report a case of spontaneous resorption of intradural disc material in a patient with recurrent intradural lumbar disc herniation and review magnetic resonance (MR) imaging and histopathological findings. Intradural lumbar disc herniation is rare, and most patients with this condition require surgical intervention due to severe leg pain and vesicorectal disturbance. In the present case, however, the recurrent intradural herniated mass had completely disappeared by 9 months after onset. Histological examination of intradural herniated disc tissue demonstrated infiltrated macrophages and angiogenesis within the herniated tissue, and Gd-enhanced MR images showed rim enhancement not only at the initial presentation, but also at recurrence. The authors conclude that when rim enhancement is present on Gd-enhanced MR images, there is a possibility of spontaneous resorption even though the herniated mass may be located within the intradural space. Moreover, when radiculopathy is controllable and cauda equina syndrome is absent, conservative therapy can be selected.
Sakai
Tsubasa
T
Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan. ts2611@hotmail.com
Tsuji
Takashi
T
Asazuma
Takashi
T
Yato
Yoshiyuki
Y
Matsubara
Osamu
O
Nemoto
Koichi
K
D000368:Aged; D001862:Bone Resorption; D004388:Dura Mater / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000503:physiopathology*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D012008:Recurrence; D012075:Remission, Spontaneous