Ann Rehabil Med.  2015 Oct;39(5):844-847. 10.5535/arm.2015.39.5.844.

Lower Extremity Radicular Pain Caused by Entrapped Sigmoid Colon Between L5 and S1 Vertebrae

• Ko S
• Park NK
• Cho KJ
• Baek JH
• Lim JW
• Choi D
• Kang S

• KMID: 2148218
• DOI: http://doi.org/10.5535/arm.2015.39.5.844

Abstract

Intestinal entrapment between two vertebral bodies is very rare. In all previous cases, it occurred by major trauma. However, the bowel entrapment between two vertebral bodies without trauma has never been reported, not to mention as the cause of lower extremity radicular pain. We describe the case of an 82-year-old female patient with right lower extremity radicular pain without recent trauma history. The patient was diagnosed sigmoid colon entrapment between the L5 and S1 vertebrae by lumbar spinal computerized tomography and magnetic resonance imaging, and showed improvement in radicular pain after manual reduction of interpositioned colon during surgery. Intestinal entrapment between two vertebrae without trauma is caused by degenerative and vacuum changes of the intervertebral disc combined with the anterior longitudinal ligament injury.

Keyword

Radiculopathy; Intervertebral disc; Colon entrapmenttebrae

MeSH Terms

Aged, 80 and over
Colon
Colon, Sigmoid*
Female
Humans
Intervertebral Disc
Longitudinal Ligaments
Lower Extremity*
Magnetic Resonance Imaging
Radiculopathy
Spine*
Vacuum

Figure

• 

  Fig. 1 Plain erect X-ray images of the abdomen show multiple air-fluid levels in the intestine (arrow head).

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  Fig. 2 (A) Axial and (B) sagittal L-spine computerized tomography images show the entrapped intestine in the L5 to S1 intervertebral space (arrow).

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  Fig. 3 (A) Axial and (B) sagittal T2-weighted MR images reveal the entrapped intestine in the L5 to S1 intervertebral space (black arrow), facet joint destruction (white arrow), and the non-contiguous ligament injury in the anterior longitudinal ligament at the disc level of L5-S1 (arrow head).

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