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Segmental abdominal wall paresis caused by lateral low thoracic disc herniation
Ivana Stetkarova1, Jiri Chrobok, Edvard Ehler
1Department of Neurology, Na Homolce Hospital, Prague, Czech Republic. ivana.stetkarova@homolka.cz
Spine
|December 20, 2007
Summary
This study describes two rare cases of thoracic disc herniation presenting as abdominal pain and muscle weakness. Conservative treatment was effective for these patients without spinal cord involvement.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Lateral thoracic disc herniation is uncommon, often presenting with subtle symptoms.
- Early diagnosis and electrophysiologic assessment are crucial for managing thoracic disc herniation.
- Conservative management is preferred when spinal cord function is preserved.
Observation:
- Two patients presented with spontaneous deep unilateral abdominal pain and unilateral partial paresis of the obliquus abdominis muscle.
- Magnetic resonance imaging revealed thoracic disc protrusions at T10-L1 levels.
- Electromyography (EMG) confirmed axonal root impairment, while evoked potentials ruled out spinal cord involvement.
Findings:
- Patients experienced pain relief with nonsteroidal anti-inflammatory drugs and periradicular injections.
- Muscle strength normalized within 3-6 months, supported by EMG findings of reinnervation.
- Conservative treatment, including medication and injections, proved effective.
Implications:
- Thoracic disc herniation can mimic abdominal pathology, necessitating a thorough differential diagnosis.
- Conservative management is a viable and effective treatment for thoracic disc herniation without neurological deficits.
- This case series highlights the importance of considering spinal causes for abdominal pain and weakness.
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