Lower thoracic disc herniation mimicking lower lumbar disk disease: A case report

Area of Science:

• Neurosurgery
• Spinal Surgery
• Radiology

Background:

• Thoracic disk herniation is a rare condition, accounting for only 0.15% of all disk herniations.
• Its clinical manifestations are often varied and confusing, making diagnosis challenging.
• Radicular pain down the leg as the sole presenting symptom is particularly uncommon.

Purpose of the Study:

• To report a rare case of lower thoracic disk herniation presenting as acute leg sciatica-like pain.
• To emphasize the diagnostic challenges and potential discordance between clinical presentation and imaging findings.
• To illustrate the effectiveness of surgical intervention in managing such cases.

Main Methods:

• A case report of a 34-year-old male patient with a history of intermittent back pain.
• Clinical examination suggested a distal lumbar problem despite the patient's symptoms.
• Magnetic Resonance Imaging (MRI) revealed T-12 L-1 disk herniation.

Main Results:

• The patient presented with acute, sciatica-like pain radiating down the leg and vague abdominal pain.
• Clinical findings were incongruent with the MRI-identified lower thoracic disk herniation.
• Open discectomy resulted in complete resolution of the acute pain.

Conclusions:

• Lower thoracic disk herniation can compress lumbosacral nerve roots, causing symptoms that mimic lumbar radiculopathy.
• A high index of suspicion is required to correlate clinical symptoms with imaging findings in suspected thoracic disk herniation.
• Prompt surgical decompression, such as open discectomy, can effectively alleviate symptoms and improve outcomes.