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Open Access Case report

Posteriorly migrated thoracic disc herniation: a case report

Naohisa Miyakoshi*, Michio Hongo, Yuji Kasukawa, Yoshinori Ishikawa and Yoichi Shimada

Author Affiliations

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

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Journal of Medical Case Reports 2013, 7:41  doi:10.1186/1752-1947-7-41

Published: 12 February 2013

Abstract

Introduction

Posterior epidural migration of thoracic disc herniation is extremely rare but may occur in the same manner as in the lumbar spine.

Case presentation

A 53-year-old Japanese man experienced sudden onset of incomplete paraplegia after lifting a heavy object. Magnetic resonance imaging revealed a posterior epidural mass compressing the spinal cord at the T9-T10 level. The patient underwent emergency surgery consisting of laminectomy at T9-T10 with right medial facetectomy, removal of the mass lesion, and posterior instrumented fusion. Histological examination of the mass lesion yielded findings consistent with sequestered disc material. His symptoms resolved, and he was able to resume walking without a cane 4 weeks after surgery.

Conclusions

Pre-operative diagnosis of posterior epidural migration of herniated thoracic disc based on magnetic resonance imaging alone may be overlooked, given the rarity of this pathology. However, this entity should be considered among the differential diagnoses for an enhancing posterior thoracic extradural mass.

Keywords:
Intervertebral disc herniation; Posterior migration; Thoracic spine