Back to Journals » Journal of Pain Research » Volume 12

Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review

Authors Rong Y, Wang J, Sui T, Liu W, Luo Y, Cai W

Received 7 January 2019

Accepted for publication 25 June 2019

Published 31 July 2019 Volume 2019:12 Pages 2403—2410

DOI https://doi.org/10.2147/JPR.S200632

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr E Alfonso Romero-Sandoval


Yuluo Rong,* Jiaxing Wang,* Tao Sui, Wei Liu, Yongjun Luo, Weihua Cai

Department of Orthopaedics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Objective: 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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]