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Thoracic Disc Herniation Mimicking Acute Lumbar Disc Disease

Lyu, Rong-Kuo MD; Chang, Hong-Shiu MD; Tang, Lok-Ming MD, MSc; Chen, Sien-Tsong MD

Case Report

Study Design. Case report of a 49-year-old woman with a lower thoracic disc herniation mimicking acute lumbosacral radiculopathy.

Objective. To describe an unusual case of thoracic disc herniation mimicking acute lumbar disc disease.

Summary of Background Data. Symptomatic thoracic disc herniation is rare and its clinical manifestations differ widely from those of cervical and lumbar disc herniations. Midline back pain and signs of spinal cord compression progressing over months or years are the predominant clinical features. Acute and subacute thoracic disc herniation occurs in less than 10% of patients, and isolated root pain is unusual.

Methods. A 49-year-old woman had acute low back pain radiating into the left buttock and the lateral aspect of the left leg and left foot. Magnetic resonance imaging study showed a bulging disc and posterior osteophytes at T11-T12.

Results. Surgical removal of the herniated disc and osteophytes rapidly relieved her symptoms and neurologic deficits. A follow-up neurologic examination 3 years later showed normal motor and sensory functions, although low back soreness was noted occasionally.

Conclusion. A case of thoracic disc herniation mimicking an acute lumbosacral radiculopathy is presented. Compression of the lumbosacral spinal nerve roots at the lower thoracic level after exit from the lumbar enlargement may be the mechanism for this unusual presentation.

From the Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan.

Acknowledgment date: April 30, 1998.

Acceptance date: July 10, 1998.

Device status category: 1.

Address reprint requests to: Sien-Tsong Chen, MD; Department of Neurology; Chang Gung Memorial Hospital; 199, Tung Hwa North Road, Taipei; Taiwan; E-mail:

© 1999 Lippincott Williams & Wilkins, Inc.