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Paraparesis in a child with a herniated thoracic disc
M Brennan1, J C Perrin, A Canady
1Department of PM&R, William Beaumont Hospital, Royal Oak, MI 48072.
Archives of Physical Medicine and Rehabilitation
|November 1, 1987
Summary
A rare case of herniated thoracic disc in an 11-year-old boy, initially missed by standard imaging, was diagnosed with MRI. Prompt surgical intervention led to significant recovery of motor function.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Spinal Imaging
Background:
- Herniated thoracic discs are uncommon, particularly in pediatric populations.
- Minor trauma can precipitate disc herniation, leading to neurological deficits.
- Diagnostic challenges exist due to the rarity and subtle presentation of thoracic disc herniations.
Observation:
- An 11-year-old boy presented with paraparesis following minor trauma.
- Initial diagnostic imaging, including myelogram and CT scan, of the thoracic spine was normal.
- Magnetic resonance imaging (MRI) revealed a small herniation at the T4-T5 level.
Findings:
- Surgical exploration (laminectomy) identified disc material adhered to the dura.
- The herniated disc was successfully removed.
- The patient experienced progressive neurological recovery.
Implications:
- MRI is crucial for diagnosing subtle thoracic disc herniations in children.
- Early diagnosis and surgical decompression are vital for favorable neurological outcomes.
- This case highlights the importance of considering rare diagnoses in pediatric spinal injuries.