Giant Calcified Thoracic Disc Herniation in a Child
| Autor: | Nicholas Tsai, Hua Li, Xinwei Wang, Wen Yuan, Xuhui Zhou, Xiao-Dong Wu, Shengming Xu, Xiao-Long Sheng, Huajiang Chen |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Thorax
medicine.medical_specialty Diaphragmatic breathing Neurological examination Thoracic Vertebrae Spinal cord compression Back pain Humans Medicine Orthopedics and Sports Medicine Child medicine.diagnostic_test business.industry Calcinosis General Medicine medicine.disease Surgery Radiography Treatment Outcome Orthopedic surgery Female Intractable pain medicine.symptom business Bed Rest Intervertebral Disc Displacement Rare disease |
| Zdroj: | The Journal of Bone and Joint Surgery-American Volume. 92:1992-1996 |
| ISSN: | 0021-9355 |
| DOI: | 10.2106/jbjs.i.01652 |
| Popis: | Calcified thoracic disc herniation in childhood is a rare disease, and it differs from calcified thoracic disc herniation in adults in several respects, including the natural history, clinical presentation, treatment, and prognosis1,2. Herniation of a calcified disc occasionally leads to acute nerve-root or spinal cord compression. Conservative treatment has been recommended for the majority of patients, even those with mild neurological deficits, since spontaneous resorption of the calcified lesion can be expected1,3-8. In other rare cases, giant herniation of the disc may cause intractable pain and a progressive neurological deficit, which has been an indication for surgical treatment1,5,6,8. We report the case of a child with giant herniation of an intervertebral disc calcification in the thoracic spine and present a literature review. The parents of the patient were informed that data concerning the case would be submitted for publication, and they consented. A twelve-year-old girl presented with upper back pain for one month, preceded by a fever forty days earlier. The pain radiated to the front of the chest, was aggravated by spinal motion, particularly bending forward and deep breathing, and was relieved by analgesics. She had tenderness at the spinous processes of T2 and T3 with paraspinal muscle spasm. Spinal motion was extremely painful. Neurological examination was unremarkable, except for a minimal sensory deficit of the left T2 and T3 dermatomes. During the febrile period, the serum calcium level was 2.74 mmol/L (normal, 2.29 to 2.73 mmol/L), the serum phosphorus level was 1.60 mmol/L (normal, 0.81 to 1.45 mmol/L), and the serum alkaline phosphatase level was 157 U/L (normal, 15 to 112 U/L). The erythrocyte sedimentation rate and leukocyte count were normal. The lateral radiograph of the cervical spine indicated a … |
| Databáze: | OpenAIRE |
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