Soonchunhyang Med Sci.  2016 Dec;22(2):180-184. 10.0000/sms.2016.22.2.180.

Unusual Presentation of Bilateral Foraminal Disc Herniation

• Choi SW
• Lee JC
• Choi HS
• Shin BJ

• KMID: 2387019
• DOI: http://doi.org/10.0000/sms.2016.22.2.180

Abstract

A 64-year-old woman was admitted to Soonchunhyang University Seoul Hospital due to the aggravation of bilateral radicular pain for one month prior to her visit. She had a 30 years history of low back pain and intermittent bilateral radiating pain. A magnetic resonance imaging scan revealed a bilateral space-occupying lesion in the L5 foramen. A sagittal computed tomography scan showed a disc space-narrowing, vacuum-containing, and widening of the neural exit foramen with thinning of the pedicle and posterior vertebral body scalloping. An axial scan showed that the space-occupying lesion contained calcification and had eroded the surrounding bony structure. During surgical exploration, the atrophic L5 nerve root was identified over the mass-like lesion, and the lesion was shown to be a result of a hard, extruded disc fragment. A bilateral foraminal disc is a very rare condition that when it progresses chronically and gradually, can erode adjacent bony structures. Specific precautions are necessary during fusion surgery with a pedicle screw.

Keyword

Intervertebral disc; Foramen; Neurilemmoma; Pedicle; Diagnostic errors

MeSH Terms

Cytochrome P-450 CYP1A1
Diagnostic Errors
Female
Humans
Intervertebral Disc
Low Back Pain
Magnetic Resonance Imaging
Middle Aged
Neurilemmoma
Pectinidae
Pedicle Screws
Seoul
Cytochrome P-450 CYP1A1