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[Calcification following intradiscal injection, a continuing problem?].

M Darmoul1, M H Bouhaouala, M Rezgui

  • 1Unite de Neurochirurgie, Hôpital des FSI, La Marsa Tunisie. Mehdi.Darmoul@fmt.rnu.tn

Presse Medicale (Paris, France : 1983)
|August 16, 2005
PubMed
Summary
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Intradiscal injections of triamcinolone hexacetonide for sciatica can lead to symptomatic epidural calcifications. Surgical treatment is necessary to manage these calcifications and prevent recurrence.

Area of Science:

  • Spinal surgery
  • Radiology
  • Pharmacology

Background:

  • Intradiscal injection of triamcinolone hexacetonide was previously used for sciatica due to herniated discs.
  • This treatment was discontinued due to the risk of subsequent epidural calcification.

Observation:

  • A 40-year-old man developed extensive calcifications ten years after an L4-L5 intradiscal injection.
  • These calcifications compressed the dural sheath and required multiple surgical excisions.
  • Surgical intervention included posterior lateral grafting and osteosynthesis.

Findings:

  • Symptomatic calcifications following intradiscal injections occur in 14% to 68% of cases.
  • Recurrence of calcifications necessitates further surgical intervention.

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Implications:

  • Radical surgical treatment is essential for symptomatic calcifications post-intradiscal injection.
  • Understanding the long-term risks of epidural calcification is crucial for patient management.
  • Alternative treatments for sciatica should be considered.