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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


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

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