Probable lumbar acute noncompressive nucleus pulposus extrusion: a case report of acute pain caused by a hydrated nucleus pulposus and review of the literature

Abstract

Acute noncompressive nucleus pulposus (NP) extrusion has been widely described in veterinary medicine, especially in dogs and cats; however, cases have rarely been reported in humans. We report a rare case of acute pain caused by a hydrated NP. Magnetic resonance imaging revealed an obvious hyperintense signal on T2-weighted images at the L5/S1 segments, while computed tomography imaging and radiography revealed a mildly herniated disc at the L4/5 level and slight lumbar spondylolisthesis at the L5/ S1 segments. The operation was performed to confirm the presence of a red and swollen nerve root on the right side of the hydrated L5/S1 segment. The patient's severe pain disappeared, and full recovery was achieved months after surgery. Thus, our case demonstrated a probable lumbar acute noncompressive NP extrusion in humans and reported associated symptoms and imaging characteristics. In such circumstances, surgical management is indicated and may be associated with a good outcome.

Inflammatory Myofibroblastic Tumor of the Sciatic Nerve Mimicking Lumbar Disc Herniation: A Diagnostic Challenge

“…LDH is one of the most common causes of low back pain, and its pathogenesis includes various factors, such as stress, nutritional status, strain, and trauma, as well as hereditary, developmental, and degenerative factors [ 8 , 9 ]. In our case, the patient progressed to radiculopathy, and her symptoms and physical findings mimicked LDH.…”