Invagination of intra-abdominal structures in the lumbar intervertebral disc space.
Invagination of peritoneal or retroperitoneal structures into the intervertebral disc space of the lumbar spine is extremely rare. In this article the imaging features and clinical findings are demonstrated in four patients with intervertebral invagination of intra-abdominal structures. Plain radiographs, CT scans, and MR images showed disruption of the anterior ligamentous complex (ALC) and invagination of various structures into the disc space, including the vena cava, iliac vessels, intestine, the torn redundant anterior longitudinal ligament, retroperitoneal fat, and the psoas muscle. The invaginations occurred at the level of L3-L4 and L4-L5 in one case each and at L5-S1 in two cases. Follow-up imaging in three cases (1, 5, and 8 years respectively) showed the progression of the invagination. These cases demonstrate that a close evaluation of this condition is necessary, particularly for older patients who show disruption or laxity of the ALC, degenerative spondylosis with chronic segmental instability, and osteoporosis of the lower lumbar spine.
Department of Radiology, Chungnam National University Hospital, Daejeon, Republic of Korea.
Ji Na
JN
Kim
Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea. stkwon@cnu.ac.kr.
Soon Tae
ST
Kwon
Department of Radiology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Kyung Nam
KN
Ryu
D000005:Abdomen; D000368:Aged; D000369:Aged, 80 and over; D002828:Choristoma / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013122:Spinal Diseases / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
Longitudinal ligaments; Lumbar vertebrae; Magnetic resonance imaging; Spondylosis