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Calcific discitis with giant thoracic disc herniations in adults
Nanfang Xu1, Feng Wei1, Xiaoguang Liu1
1Department of Orthopaedics, Peking University Third Hospital, 49 Huayuan North Road, Beijing, 100191, China.
Summary
Calcific discitis in adults can cause giant thoracic disc herniations. These may spontaneously regress, suggesting a conservative "wait and watch" approach may be suitable for initial management.
Area of Science:
- Spinal Surgery
- Radiology
- Rheumatology
Background:
- Calcific discitis is typically self-limiting in children, but rare in adults.
- Giant thoracic disc herniations usually require surgery to prevent neurological damage.
Observation:
- Two adult patients with calcific discitis and myelopathy from giant thoracic disc herniations were studied.
- Both patients experienced symptom relief within 3 months with conservative management (activity restriction, NSAIDs).
Findings:
- Literature search identified four adult cases of calcific discitis and three instances of spontaneous regression of smaller calcified thoracic disc herniations.
- This study provides the first evidence of spontaneous regression in giant calcified thoracic disc herniations in adults.
Implications:
- Giant calcified thoracic disc herniations may undergo spontaneous remission.
- A conservative "wait and watch" strategy may be appropriate for initial management, even with mild myelopathy.
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