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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thoracic disc herniation is a rare and slowly progressive disease which most commonly occurs at the lower thoracic spine without any preceding trauma. We reported a case with acutely developed vesicorectal dysfunction due to a ruptured disc at Th 11-12. This symptom disappeared soon after disc removal via the transpedicular approach combined with transversectomy. This 45-year-old woman suddenly suffered, without previous trauma, from severe back pain radiating down to the posterior thighs. Since difficulty in urination and defecatory incontinence succeeded two days later, she was transferred to our hospital. Neurological examination on admission revealed anesthesia below S1, hypotonic bladder with almost perfectly preserved urinary sensation, complete lack of anal reflex, and only weak motor function in the lower extremities. Both knee and ankle jerks were diminished bilaterally. A herniated disc was initially suspected at L5-S1 on the MRI, but denied by both myelography and CT myelography. These studies showed a disc hernia compressing the cord at Th 11-12 on the left side. Since the hernia was located centrolaterally, we employed the transpedicular approach. To make removal of the more centrally located hernia easier, we further added transversectomy of the twelfth vertebra. This hernia was successfully removed under the operating microscope without further damage to the cord being incurred. We did not perform any instrumental fixation, because we thought preservation of the rib and costvertebral joint could contribute to the stability of the spine. Her vesicorectal symptom subsided immediately after the operation. She was free of any symptoms except for the remaining mild perianal numbness a year and seven months postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lower thoracic disc herniation with acutely developed vesicorectal dysfunction: case report]. 832 56

Thoracic disc herniation is a rare pathology for which surgical treatment is difficult. The discovery of asymptomatic or only slightly symptomatic lesions can be problematic, especially in cases of marked canal stenosis. The possibility of spontaneous resorption has been documented by a few case reports but there is no study on this subject. Our objective was to compare the clinical and radiological data for two groups of patients with significant thoracic herniation (occupying more than 20% of the spinal canal): one showing spontaneous resorption (group 1) and the other persistence of the lesion during follow up (group 2). The physiological processes of thoracic herniation are also discussed. We present a retrospective study of our database of patients with thoracic hernia. Only subjects who initially showed signs of slight or absent myelopathy (Frankel D or E) were included. Group 1 and 2 are composed of 12 and 17 patients respectively. The clinical and radiological data are compared. The two groups were not different for the following parameters: age, sex ratio, disc calcification, size, trajectory, side, hernia level. Other parameters were evaluated and were not associated with a higher rate of resorption: disc calcification, intramedullary hypersignal in T2 sequence, calcification of the posterior common vertebral ligament, calcification of another disc and Scheuerman's disease. Asymptomatic thoracic disc herniation is a condition that can disappear spontaneously, even in the case of a large lesion. To date, there are no clinical or radiological data that can predict such an evolution.
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PMID:What are the possibilities of spontaneous resorption of a thoracic disc herniation occupying more than 20% of the spinal canal in the asymptomatic subject? Comparative study. 2870 37