Case report: Acute calcific discitis with intravertebral disc herniation in the dorsolumbar spine (original) (raw)
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Two New Cases of Symptomatic Discal Calcifications in Adults
Discal calcifications can be an etiology of back pain in adults. It is a clinical entity well described in children but rarely reported in adults. Therefore, current knowledge of this entity is based on the pediatric population and rare literature exists regarding the natural history and management of this condition in adults. It is generally self limited and only requires symptomatic treatment. Imaging plays an important role in the diagnosis of this entity helping the patient avoid further invasive investigational and therapeutic procedures. We report two new cases of symptomatic disc calcification, occurring in the thoracic spine of a 61 year-old-patient and in the lumbar spine of a 79-year-old-patient. In both cases, the final diagnosis was based on radiological findings and certified by clinical evolution of the symptoms.
Lumbar Intervertebral Disc Calcification A Case.pdf
Intervertebral disc calcification is an uncommon cause of spinal pain and really rare in lumbar disc levels. The certain etiology still remains uncertain. Most of cases are asymptomatic and are diagnosed incidentally in routine scanning or during evaluation of non-specific clinical complaints. A 63-year-old male presented with waist and both legs pain. There was no definite history of trauma or infection. Imaging of the lumbar spine showed calcification of the inter vertebral disc at L1-2 level. The patient was kept on medical therapy. The complaints showed near-complete resolution on 3-month follow-up.
Intervertebral disc calcifications in children
Clinical Imaging, 2009
Purpose. This study was done to assess the presence of both asymptomatic and symptomatic intervertebral disc calcifications in a large paediatric population. Materials and methods. We retrospectively reviewed the radiographs taken during the past 26 years in children (age 0-18 years) undergoing imaging of the spine or of other body segments in which the spine was adequately depicted, to determine possible intervertebral disc calcifications. The following clinical evaluation was extrapolated from the patients' charts: presence of spinal symptoms, history of trauma, suspected or clinically evident scoliosis, suspected or clinically evident syndromes, bone dysplasias, and preor postoperative chest or abdominal X-rays. Results. We detected intervertebral disc calcifications in six patients only. Five calcifications were asymptomatic (one newborn baby with Patau syndrome; three patients studied to rule out scoliosis, hypochondroplasia and syndromic traits; one for dyspnoea due to sunflower seeds inhalation). Only one was symptomatic, with acute neck pain. Calcifications varied in number from one in one patient to two to five in the others. Conclusions. Apart from the calcification in the patient with cervical pain, all calcifications were asymptomatic and constituted an incidental finding (particularly those detected at the thoracic level in the patient studied for sunflower-seed inhalation). Calcification shapes were either linear or round. Our series confirms that intervertebral disc calcifications are a rare finding in childhood and should not be a source of concern: symptomatic calcifications tend to regress spontaneously within a short time with or without therapy and immobilisation, whereas asymptomatic calcifications may last for years but disappear before the age of 20 years.
Pediatric intervertebral disc calcification: A no touch lesion
2012
Intervertebral disc calcification (IVDC), though rare, remains an important differential of pediatric spinal pain. A 7-year-old boy presented with sudden-onset severe neck pain and restricted movements. There was no definite history of trauma or infection. Imaging of the cervical spine showed calcification of the intervertebral disc at C2–3 level, with significant posterior protrusion into the spinal canal causing compression of the cervical spinal cord. The child was kept on conservative management. The calcification and posterior protrusion showed near-complete resolution on 3-month follow-up. This case report emphasizes that childhood IVDC is a benign condition which commonly resolves spontaneously, without any surgical intervention and neurological sequelae.
To cut or not to cut? A case report on pediatric intervertebral disc calcification
Surgical Neurology International, 2021
Background: Intervertebral disc calcification (IVDC) is a rare cause of acute spinal pain in pediatric patients. The most common symptom is back or neck pain, but muscle spasm, muscle weakness, and sensory loss also occur. Many patients have an alarming presentation and radiological findings concerning for spinal cord compression. Case Description: A 10-year-old female presented with 2 weeks of worsening back pain and restricted neck flexion with no history of preceding trauma. Magnetic resonance imaging (MRI) showed T4/5 and T5/6 vertebral disc calcification and posterior herniation causing thoracic spinal cord compression. Despite concerning imaging findings, we decided to manage this patient conservatively with nonsteroidal anti-inflammatory drugs, leading to the improvement of symptoms within 9 days, and resolution of all pain within 1 month after hospital discharge. At 6 months follow-up, MRI showed complete resolution of calcification within the spinal canal. Conclusion: This ...
Cervical intervertebral disc calcification in children
Child's Nervous System, 1987
Intervertebral disc calcification in children is a rare occurrence. The clinical symptoms and signs are distinctively confined to the cervical area with pain, limitation of motion, and torticollis. Long tract signs or radicular involvement are extremely unusual. CT scan and cervical spinal X-ray films shown the calcification to be in the nucleus pulposus with anterior or posterior mild protrusion into the spinal canal. Recovery without neurological sequelae is the rule in most of the pediatric cases with conservative treatment. Intervertebral disc calcification does not necessarily disappear with the onset of clinical symptoms. A case with persistent and even denser calcification at the same level of intervertebral disc space at the second episode o f recurrence is illustrated.
Journal of Neurosurgery: Case Lessons, 2021
BACKGROUND Herniation of an intervertebral disc (IVD) is found predominantly in the lumbar and cervical spine of both children and adults, but herniated IVDs of the thoracic spine are a rare occurrence. However, approximately 40% of herniated thoracic disc cases are calcified. Approximately 0.65% of all spinal herniations are calcified herniated thoracic discs (CHTDs). CHTDs can be treated conservatively or invasively, depending on the symptoms and degree of neurological deficit present. OBSERVATIONS The authors report a 44-year-old male with near complete reabsorption and disappearance of a CHTD. A review of the available literature indicates that there are only seven adult patients in whom this phenomenon has been reported. LESSONS Determining the best form of invasive treatment is a challenge for surgeons given the complexity of this condition. While the disappearance of calcified herniated discs of the lumbar and cervical spine has been reported, reports of the regression of CHT...
Pediatric Idiopathic Intervertebral Disc Calcification
Pediatric Neurology, 2016
Objective To review pediatric idiopathic intervertebral disc calcification (PIIVDC) within a single center and within the literature to outline the disease course, management, and outcome. Study design A retrospective chart review was performed spanning the period between January 2001 and February 2016 for diagnoses of PIIVDC. Patient age, sex, symptoms, and history and physical and neurologic findings were reviewed. Laboratory and imaging findings, management, follow-up, and outcome also were studied. Results Nine cases of PIIVDC were identified; they included 6 male and 3 female patients, with an age range of 23 months to 12 years. Two patients were asymptomatic, and PIIVDC was discovered incidentally. Of the remaining 7 patients, 5 presented with neck and/or back pain, 1 with painless torticollis, and 1 with painful torticollis. One patient reported neurologic symptoms of pain radiating along 1 dermatome. Disc spaces affected were 5 cervical, 4 thoracic, and 2 lumbar, with 2 patients having more than 1 space affected. All patients were managed conservatively. In 1 case, symptoms and lesions persisted after 5 years, but the remainder had complete symptom resolution, generally within 6 months. Conclusions The etiology of PIIVDC remains unknown but appears to occur spontaneously, without preceding trauma or underlying medical condition. A conservative approach to patients without severe neurologic deficit with outpatient follow-up is supported.