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Akbar Farzannia, Ghaffar Shokouhi, and Shahram Hadidchi

pigment leads to degenerative changes in cartilage, intervertebral disc, and other connective tissues by an unknown mechanism. 6 Limitation of motion and ankylosis of the lumbosacral segment are late findings. 6 Although intervertebral disc degeneration is frequently found in cases of alkaptonuria, lumbar disc herniation as the presenting feature of alkaptonuria is not common. 2 We report on three patients with lumbar disc herniation who underwent discectomy. The diagnosis of alkaptonuria was suspected in each case when a black nucleus pulposus was seen

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Hyung-Lea Cho, Jin-Sung Kim, Sung Suk Paeng, and Sang-Ho Lee

as an incidental finding with or without other congenital syndromes. Butterfly vertebrae can be asymptomatic for a long time because they do not cause any neurological problems, but other body systems that may have been affected during embryogenesis should be carefully evaluated when an anomaly like this is discovered. 12 In the present report, we describe a novel case of a butterfly vertebra in a patient with a herniated disc that presented as radiculopathy. This is the first known case of disc herniation that originated from the sagittal cleft of butterfly

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Karin R. Swartz and Gregory R. Trost

Recurrent lumbar disc herniation is a common disease process. It has been noted to occur in 5 to 15% of cases surgically treated for primary lumbar disc herniation. Outcomes in one series approached those after the initial operations, although this is not the case in the experience of most surgeons.

The removal of recurrent lumbar disc herniations requires meticulous surgical technique. Great care is taken to identify the osseous margins of the previous surgical site. Identification and dissection of scar from the dura mater is greatly aided with the use of a microscope.

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Intradural cervical disc herniation

Case report and review of the literature

Wolfgang Börm and Torsten Bohnstedt

I ntradural disc herniation is a well known but rare entity, especially in the cervical region. According to Epstein, et al., 4 intradural disc herniation accounts for less than 0.3% of all disc herniations, and only 3% occur in the cervical region, whereas 5 and 92% are localized in the thoracic or lumbar spinal canal, respectively. In reviewing the literature, we could find only 10 cases of intradural disc herniation at the cervical level, and our present case raises the total to 11. 1–4, 8–13 Case Report Presentation This 40-year-old man

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Kerry L. Bernardo, Robert L. Grubb, William S. Coxe, and Charles L. Roper

P osterior and posterolateral herniations of cervical intervertebral discs cause several well-known clinical syndromes. These neurological symptoms often bring the patient to the attention of the neurosurgeon. Anterior cervical disc herniations are considerably less common, and when they are symptomatic the diagnosis is often not established correctly prior to surgery. 10 Dysphagia caused by hypertrophic anterior cervical osteophytes is now a well-recognized clinical entity and has recently been reviewed extensively. 3, 5, 7 This report describes a case of

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Taewook Kang, Si Young Park, Gun Woo Park, Soon Hyuck Lee, Jong Hoon Park, and Seung Woo Suh

M icroendoscopic discectomy has been a common surgical procedure in patients with lumbar disc herniation. 1 Percutaneous discectomy was first introduced by Hijikata in 1973. 2 Kambin and Sampson introduced an endoscopic discectomy technique. 3 Since then, new percutaneous endoscopic discectomy techniques have been developed. Minimally invasive spine surgery, which focuses on preservation of normal spine anatomy, is replacing conventional discectomy. 4 Recently, percutaneous endoscopic lumbar discectomy is becoming widely used for the treatment of lumbar disc

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Taşkan Akdeniz, Tuncay Kaner, İbrahim Tutkan, and Ali Fahir Ozer

-approach transforaminal lumbar interbody fusion for the treatment of lumbar foraminal stenosis. Clinical article . J Neurosurg Spine 13 : 500 – 508 , 2010 7 Jenis LG , An HS : Spine update. Lumbar foraminal stenosis . Spine (Phila Pa 1976) 25 : 389 – 394 , 2000 8 Kirkaldy-Willis WH , Farfan HF : Instability of the lumbar spine . Clin Orthop Relat Res 165 : 110 – 123 , 1982 9 Kornberg M : Sciatica contralateral to lumbar disk herniation . Orthopedics 17 : 362 – 364 , 1994 10 Lee DY , Lee SH : Recurrent lumbar disc herniation with

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Stéphane Fuentes, Phillipe Metellus, Henry Dufour, and François Grisoli

The authors present the case of traumatic thoracic disc herniation in a 39-year-old man who was involved in a high-speed motorcycle accident. The patient presented with complete paraplegia and loss of sensorimotor function from the T-10 level down, priapism, and imperforate anus. Emergency spinal magnetic resonance (MR) imaging demonstrated the presence of a predominantly left-sided T9–10 intervertebral disc herniation associated with spinal cord contusion ( Fig. 1 ). Computerized tomography (CT) scanning revealed minimal compression of the T9–10 vertebral

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High cervical disc herniation presenting with C-2 radiculopathy

Case report and review of the literature

Vivek R. Deshmukh, Harold L. Rekate, and Volker K. H. Sonntag

T he most common locations for disc herniation in the cervical spine are C5–6 and C6–7. 2, 6 High cervical disc herniations (C2–3) are extremely rare 3, 7, 10 but appear to have a predilection for elderly patients. 7 They usually cause myelopathy. 1, 3, 7, 10 We report on a patient with a C2–3 disc herniation that caused isolated C-2 radiculopathy and who underwent surgery via a posterior extradural approach. Case Report History and Presentation This 78-year-old, right-handed man with progressive gait ataxia, urinary incontinence, and mild

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George Varughese and Gilbert R. C. Quartey

underwent decompressive procedures because of complicating acute intervertebral disc herniations. Case Reports Four brothers, all suffering from chronic low-back pain, had managed to carry on with their regular activities as farmers until they became disabled with acute sciatica necessitating urgent hospitalization. Both their parents apparently had lumbosciatic problems for which operations were done elsewhere years before. The clinical presentations and findings of the four brothers were so similar, to avoid repetition, we have summarized their data in Tables 1