PDF(Pubmed)
Abstract：
Acute and chronic lower back pain can be commonly caused by intervertebral disc prolapse. This prolapse usually occurs in the dorsal direction and towards the anterior epidural space. In extremely rare cases, this migration/herniation can be seen approaching the posterior epidural space. One such rare instance has been recorded and described in our patient, a 53-year-old with a history of hypertension who presented with persistent lower back pain, radicular in nature, and recent acute aggravation, leading to mobility impairment. The patient experienced numbness in the lower limbs, urinary incontinence, and irregular bowel movements. Sensory deficits were noted along the L3 dermatome. The patient underwent an L3 laminectomy, revealing extruded disk fragments causing the compression. After surgery, the patient\'s power in the lower limbs began to improve, with significant recovery by discharge and complete resolution of bowel and bladder incontinence. This case highlights the diagnostic and therapeutic challenges of posterior epidural mass-like lesions in the lumbar spine, emphasizing the importance of prompt surgical intervention in restoring neurological function. The successful outcome underscores the significance of early diagnosis and intervention in such cases, ultimately improving the patient\'s quality of life.
摘要：
急性和慢性下背痛通常由椎间盘脱垂引起。这种脱垂通常发生在背侧并朝向硬膜外前腔。在极少数情况下，这种迁移/疝可以看到接近硬膜外后间隙。在我们的病人身上记录并描述了一个罕见的例子，一名53岁有高血压病史的患者，表现为持续的下背部疼痛，自然界中的神经根，最近严重的恶化，导致行动不便。病人下肢麻木,尿失禁,和不规则的排便.沿着L3皮刀注意到感觉缺陷。病人接受了L3椎板切除术,揭示挤压的磁盘碎片导致压缩。手术后,病人下肢的力量开始改善，通过出院和肠和膀胱失禁的完全解决显着恢复。该病例突出了腰椎后硬膜外肿块样病变的诊断和治疗挑战，强调及时手术干预对恢复神经功能的重要性。成功的结果强调了在这种情况下早期诊断和干预的重要性。最终改善患者的生活质量。
