Rationale: We report a case of Schmorl node induced multiple radiculopathy. Patient concerns: A 70-year-old female patient complained of lower back pain in the left leg accompanied by numbness and weakness. Diagnosis: Radiographs showed obvious osteoporosis in the lumbar vertebrae. Computed tomography demonstrated a hole in the upper posterior half of the L2 vertebral body. Magnetic resonance imaging of the lumbar spine revealed a herniated disc involving a protrusion at the posterior wall of the L2 vertebral body, which was present in the left lateral and dorsal epidural spaces. There was significant lumbar stenosis at the L2 vertebral body secondary to dural sac compression due to the mass. Intervention: Left-sided hemilaminectomy was performed at L2 with screw fixation at L1–3. Intraoperatively, the severely ruptured disc compression in the dural sac and nerve root was removed. Outcomes: The patient's leg pain was immediately resolved, and her back pain was reduced. The patient recovered normal motor function at 20 days after surgery. Lessons: A Schmorl node can progress and break through the lumbar vertebral body, resulting in nerve compression. A large proximal herniated mass can cause distal multiple radiculopathy. Therefore, this special case of Schmorl node with multiple radiculopathy should be treated by removing the proximal herniated nucleus pulposus from the vertebral body.
Introduction: Intradural schwannomas can occur at any level of the spine. According to the literature, approximately 8% of intradural schwannomas occur in the atlantoaxial spine, and these tumors are usually located in the posterolateral or lateral spinal cord. In contrast, tumors in the ventral midline of the spinal cord are relatively rare. Patient concerns: A 47-year-old female presented with progressively worsening neck pain and paresthesias in both upper and lower limbs for the past 5 years. Diagnosis: Based on Magnetic Resonance Imaging and histopathological findings, she was diagnosed with ventral midline primary schwannoma of the cervical spinal cord. Interventions: The patient was treated with surgical resection. Outcomes: Follow-up visit at 2 years after the surgery showed that the patient is neurologically intact and free of disease. Conlusion: In summary, for the tumors in the ventral midline of the atlantoaxial spinal cord, the preferred treatment is complete surgical resection by the posterior approach compared to the anterior approach, which often improves clinical symptoms or achieves a healing effect.
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