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KMID : 1214920160220020180
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Soonchunhyang Medical Science
2016 Volume.22 No. 2 p.180 ~ p.184
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Unusual Presentation of Bilateral Foraminal Disc Herniation
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Choi Sung-Woo
Lee Jae-Chul
Choi Hyung-Suk
Shin Byung-Joon
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Abstract
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A 64-year-old woman was admitted to Soonchunhyang University Seoul Hospital due to the aggravation of bilateral radicular pain for one month prior to her visit. She had a 30 years history of low back pain and intermittent bilateral radiating pain. A magnetic resonance imaging scan revealed a bilateral space-occupying lesion in the L5 foramen. A sagittal computed tomography scan showed a disc space-narrowing, vacuum-containing, and widening of the neural exit foramen with thinning of the pedicle and posterior vertebral body scalloping. An axial scan showed that the space-occupying lesion contained calcification and had eroded the surrounding bony structure. During surgical exploration, the atrophic L5 nerve root was identified over the mass-like lesion, and the lesion was shown to be a result of a hard, extruded disc fragment. A bilateral foraminal disc is a very rare condition that when it progresses chronically and gradually, can erode adjacent bony structures. Specific precautions are necessary during fusion surgery with a pedicle screw.
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KEYWORD
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Intervertebral disc, Foramen, Neurilemmoma, Pedicle, Diagnostic errors
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