The Spine Journal 15 (2015) e27–e28
Sequestrated lumbar disc fragment mimicking ventral epidural abscess
longitudinal ligament. There was no significant epidural abscess. Ruptured disc fragments between the T12 vertebral body and posterior longitudinal ligament were removed (Fig. 2).
A 72-year-old woman presented with a 1-month history of low back pain, weakness, and numbness of lower extremities. On examination, there was weakness of bilateral lower limbs (3 of 5) and absence of deep tendon reflexes. She had history of herniated disc surgery two times, 6 weeks ago. Contrast-enhanced magnetic resonance imaging (MRI) revealed a ventral epidural mass–like lesion at the level of T12. The lesion was homogeneously isointense on MRI scans. On the contrast-enhanced MRI scans, there was peripheral contrast enhancement of the lesion, which is typical for an epidural abscess (Fig. 1). Previous T12 laminectomy was extended, and right T12–L1 facet was removed. A hard mass palpated under the posterior
Ergun Karavelioglu, MD Mehmet Gazi Boyaci, MD Usame Rakip, MD Arda Aydogmus, MD Department of Neurosurgery School of Medicine Afyon Kocatepe University Izmir Rd 8 km Afyonkarahisar, T€ urkiye FDA device/drug status: Not applicable. Author disclosures: EK: Nothing to disclose. MGB: Nothing to disclose. UR: Nothing to disclose. AA: Nothing to disclose.
Fig. 1. (Left) Sagittal contrast-enhanced T1-weighted, (Middle) axial T1-weighted, and (Right) axial contrast-enhanced T1-weighted magnetic resonance images show peripheral contrast enhanced mass.
http://dx.doi.org/10.1016/j.spinee.2015.06.054 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
E. Karavelioglu et al. / The Spine Journal 15 (2015) e27–e28
Fig. 2. Intraoperative image.