Journal of Pain Research (Jul 2019)
Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review
Abstract
Yuluo Rong,* Jiaxing Wang,* Tao Sui, Wei Liu, Yongjun Luo, Weihua CaiDepartment of Orthopaedics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, People’s Republic of China*These authors contributed equally to this workObjective: To report a rare case of cervical intradural disc herniation (IDH) with Brown-Séquard syndrome and to review the related literature.Methods: Pathogenesis, preoperative diagnosis, and the surgical technique are discussed, and previous literature reports are reviewed.Results: A 44-year-old woman complained of weakness of the left upper and lower extremities and paresthesias in the right limbs after a bicycle ride 3 days earlier. She had a history of neck pain for 2 years prior. CT showed obvious ossification of the posterior longitudinal ligament (OPLL), and MRI revealed C3-7 disc herniations, with a positive “halo sign” around the herniated C4/5. We performed emergency decompression through anterior cervical corpectomy, and vertebrotomy decompression and fusion. At review 3 months after surgery, the patient’s neck pain was markedly relieved, and motor strength in the limbs had improved. At 1 year after surgery, she had recovered completely.Conclusion: Cervical IDH is a rare condition that may be related to the traumatic inflammatory response and OPLL. Relatively rare imaging features such as the hawk-beak sign, halo sign, Y sign, and epidural gas sign could help in preoperative diagnosis. Prompt anterior cervical decompression is the preferred treatment for this condition.Keywords: cervical intradural disc herniation, Brown-Séquard syndrome, ossification of posterior longitudinal ligament, cerebrospinal fluid leakage, surgical treatment
