Related Experiment Videos
Contained and noncontained lumbar disc herniation in the same patient. Two case reports
B Jönsson1, R Johnsson, B Strömqvist
1Department of Orthopaedics, University Hospital, Lund, Sweden.
Study Design:
A case report containing description of symptoms, signs, and selected treatment in two patients with lumbar disc herniation where the type of herniation changed from contained to noncontained in less than 1 year.
Objectives:
To demonstrate the difference in clinical appearance related to the type of herniation.
Summary Of Background Data:
The clinical appearance of lumbar disc herniation regarding onsets of symptoms, severity of pain, and clinical findings are related to the type of herniation, as is the treatment.
Methods:
Two cases reports are presented with description of anamneses, clinical findings, neuroradiographic findings, and treatment.
Results:
Both patients suffered from a transient left-side sciatica due to a contained lumbar disc herniation, improved by physiotherapy. After several months, both patients had an instantaneous increase in contralateral leg pain, and the recurrent, intense pain was caused by a sequestration of the previous contained herniation. The neurologic findings were more severe, and the patients were operated on, with subsequent improvement.
Conclusions:
The case reports illustrate the difference in clinical appearance of disc herniation related to the type of herniation, with a more aggressive clinical appearance in conjunction with perforation of the posterior longitudinal ligament with extrusion of disc material.