Thoracic Disc Herniation Mimicking Acute Lumbar Disc Disease

Abstract

A case of thoracic disc herniation mimicking an acute lumbosacral radiculopathy is presented. Compression of the lumbosacral spinal nerve roots at the lower thoracic level after exit from the lumbar enlargement may be the mechanism for this unusual presentation.

Thoracic Disk Herniation Manifesting as Sciatica-Like Pain -Two Case Reports-

“…2,8,10) The most common presentations of thoracic disk herniation are midline back pain and myelopathy, 8,10) but sciatica-like pain caused by thoracic cord compression due to tumor, kyphosis, and others is also known. 6,11) Moreover, sciatica-like pain has also been the main or first presenting symptom of thoracic disk herniation.…”

“…8,10) Among the symptoms of thoracic disk herniation, sciatica-like pain or radiculopathy of the lower extremity are rare as major complaints, whereas myelopathy due to cord compression is more typical. However, a few cases of sciatica have been caused by compressive lesions of the spinal cord at the cervical or thoracic level.…”

“…6,9,11) Cord compression is sometimes known to cause burning pain or tract pain that refers to areas below the level of the lesion, due to irritation of the ascending spinothalamic tracts, but this pain is usually diffuse or vague, and fails to conform to a dermatomal distribution. 3,4,6,9) Therefore, the differential diagnosis includes lumbar disk herniation, extraspinal peripheral lesion, spinal tumors, cervical myelopathy, multiple sclerosis, and other spinal cord or even intracranial pathologies, 1,2,4,8,9,11) because this sciatica-like pain can confound the confirmation of cord compression caused by thoracic disk herniation. We report two cases of sciatica-like pain caused by thoracic disk herniation.…”

Two brothers with a symptomatic thoracic disc herniation at T11–T12: clinical report

“…The etiopathogenesis of thoracic disc herniations is largely unknown, but according to the literature they may be linked CT computerized tomography, MR magnetic resonance, T thoracic to trauma [9], Scheuermann's disease [6,15] or a degenerative back [10]. The young age of these brothers, both in their early thirties, and the similarity of their disc herniation, suggest a familial predisposition.…”

“…On the other hand, they are frequently overlooked by clinicians who are unaware of their diverse and often misleading clinical presentation, this can include axial, thoracic or abdominal pain syndromes, non-radicular pain in one or both legs, claudication, sensory disturbances, as well as problems with micturition and defaecation [5,7,9,11,14,17,19]. Symptoms are usually slowly progressive, but may also have a more (sub)acute or even relapsing-remitting course.…”