title: Calcific discitis with giant thoracic disc herniations in adults.
abstract: Calcific discitis is a self-limiting process most commonly seen in the cervical spine of children. Rare literature exists regarding the natural history and management of this condition in adults, especially when it presents as a giant thoracic disc herniation into the spinal canal. Giant herniations in the thoracic spine are typically surgically removed to reduce the chance of permanent neurologic deficit from spinal cord compression. However, when associated with calcific discitis, they may undergo spontaneous regression with the need for surgery obviated.
  
  
  
  Medical records and radiographic studies of two adult patients with calcific discitis and myelopathy due to spinal cord compression by giant thoracic disc herniations were retrospectively reviewed. Search of the literature on calcific discitis in adults and spontaneous regression of calcified thoracic disc herniations was separately performed.
  
  
  
  Both patients were young male adults presenting with back pain and early signs of myelopathy. With restriction of activities and oral NSAIDs, their symptoms were relieved within 3 months. Four adult cases of calcific discitis (characteristic central calcification confined within the nucleus pulposus) and three instances of spontaneous regression of small- to medium-sized thoracic calcified disc herniations were identified from the literature.
  
  
  
  The demonstration of spontaneous resorption of giant calcified thoracic disc herniations in two adult patients with calcific discitis supplements the existing literature and provides the first evidence that giant calcified thoracic disc herniations may still undergo spontaneous remission and a "wait and watch" strategy may be justified at least in the initial management of these patients, even with the presence of mild myelopathy.
authors.affiliation: Department of Orthopaedics, Peking University Third Hospital, 49 Huayuan North Road, Beijing, 100191, China.
authors.forename: Nanfang
authors.initials: N
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, Peking University Third Hospital, 49 Huayuan North Road, Beijing, 100191, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wei
authors.affiliation: Department of Orthopaedics, Peking University Third Hospital, 49 Huayuan North Road, Beijing, 100191, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, Peking University Third Hospital, 49 Huayuan North Road, Beijing, 100191, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, Peking University Third Hospital, 49 Huayuan North Road, Beijing, 100191, China. puthliuzhongjun@163.com.
authors.forename: Zhongjun
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D015299:Discitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000070614:Nucleus Pulposus / Q000000981:diagnostic imaging; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology; D013118:Spinal Cord Diseases / Q000209:etiology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Calcific discitis; Giant herniation; Spontaneous regression; Thoracic disc herniation; Thoracic myelopathy
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