T2-3 Thoracic disc herniation with myelopathy.
We report a case of thoracic disc herniation in a 53-year-old woman who presented to the Emergency Department (ED) with a 2-week history of acute lower back numbness and intermittent fecal incontinence. On examination, she had lower extremity hyperreflexia, an abnormal gait, and lower lumbar pain but lacked any radicular findings. A magnetic resonance imaging scan revealed a large focal paracentral herniated disc at the T2-3 level. The patient underwent successful T2-3 anterior discectomy with T2-3 rib autograft fusion. Nine months after surgery her weakness and gait had improved, but she continued to have recurrent intermittent fecal incontinence. Thoracic disc herniation is an uncommon, but treatable cause of spinal cord compression. Prompt recognition and early treatment are the keys to preventing permanent neurologic sequelae.
Deitch
Ken
K
Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
Chudnofsky
Carl
C
Young
Michael
M
D017586:Diskectomy; D004636:Emergency Service, Hospital; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020127:Recovery of Function; D013117:Spinal Cord Compression / Q000150:complications / Q000209:etiology* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000601:surgery