ǂA ǂcalcified cervical intervertebral disc in child and a thoracic disc calcification in an adult with posterior herniation-radiographic, computed tomography and magnetic resonance imaging findings

Abstract

Background. Nucleus pulposus calcification in children is a relatively rare but well known clinical syndrome, usually localized at the level of the cervical spine. The exact aetiology still remains uncertain. Calcifications ofthe intervertebral discs in adults differ from the childhood variety. They are mainly degenerative in nature and occur at the level of midthoracic and upper lumbar spine. Potentially serious complications, posterior herniation ofcalcified disc may occur in both entities. Case reports. We report two casesof the calcification of the nucleus pulposus in a seven-year-old boy at the level of C7-T1 and a case of calcified intervertebral disc T11-T12 in a forty five-year-old woman, with massive posterior herniation. Remission of symptoms was achieved with a conservative therapy alone. Clinical, radiographic, computed tomographic and magnetic resonance imaging (MRI) findings were analyzed in an attempt to investigate similarities and differences between both disease entities. Conclusion. Massive posterior herniation of calcified nucleus pulposus in a child was treated conservativelywith a favourable outeome. A disappearance of symptoms followed guick resolution of herniated calcified masses. In adult variety extruded thoracic disc calcification was of a permanent type with no tendency towards spontaneous resolution and remission of symptoms after the conservative therapy. MRI seems to be able to depict disc calcification before a conventional radiography. The widening of affected discs in a paediatric patient was also better demonstrated by MRI It would seem to support the theory of an increased intradiscal pressure as the precursor of annulus fibrosus ruptures and consecutive calcified disc herniations.

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Data

Language:	Slovenian
Year of publishing:	2004
Typology:	1.04 - Professional Article
Organization:	OI - Institute of Oncology
Publisher:	Association of Radiology and Oncology
UDC:	616-07
COBISS:	19027417
ISSN:	1318-2099
Parent publication:	Radiology and oncology
Views:	45
Downloads:	15
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Secondary language:	English
Secondary title:	Kalcifikacija medvretenčne ploščice vratne hrbtenice pri otroku in prsne hrbtenice pri odraslem z dorzalno hernijacijo - radiografski, računalniškotomografski ter magnetnoresonančni znaki
Secondary abstract:	Izhodišča. Kalcifikacije nukleusa pulposusa pri otroku so sorazmerno redek, vendar dobro znan klinični sindrom, ki se običajno pojavlja na vratni hrbtenici. Natančen vzrok še vedno ni znan. Kalcifikacije medvretenčne ploščice odraslega so večinoma posledica degeneracije in se pojavIjajo v višini spodnje prsne in zgornje ledvene hrbtenice. Pri obeh entitetah lahko nastane resna komplikacija, posteriorna hernijacija kalcificiranega diskusa. Prikaz primera. Prikazana sta dva primera kalcificirane medvretenčne ploščice,prvi pri 7-letnem otroku v višini C7-T1 ter drugi pri 45-letni ženskiv višini T11-T12, oba z razsežno dorzalno hernijacijo. V prvem primeru je dosežena remisija s konservativnom zdravljenjem. Na podlagi analize radiografskih, računalniškotomografskih ter magnetnoresonančnih (MRI) spremembsmo ugotovili podobnosti in razlike med obema entitetama. Zaključki. Masivna dorzalna hernijacija kalcificiranega nukleusa pulposusa pri otroku je uspešno zdravljena konzervativno. Izginotje kliničnih znakov je sledilo hitri resorpciji kalcificirane diskus hernije. Pri odraslem po konzervativnem zdravljenju ni prišlo do resorpcije kalcificirane diskus hernije in kliničnih znakov izboljšanja. Z MRI je možen zgodnejši prikaz kalcifikacij. Tudi razširitev prizadetih medvretenčnih ploščic pri otroku je boljše prikazana z MRI. Razširitev kalcificiranih medvretenčnih ploščic podpira teorijo zvišanegaintradiskalnega pritiska kot vzroka rupture anulusa fibrozusa in posledične hernijacije nukleusa pulposusa.
Secondary keywords:	Intervertebral Disk;Calcinosis;Intervertebral Disk Displacement;Tomography, X-Ray Computed;Magnetic Resonance Imaging;Spinal Diseases;Radiography;Kalcinoza;Magnetna resonanca slikovna;Medvretenčna ploščica;Medvretenčna ploščica, hernija;Tomografija radiografska, računalniška;Hrbtenica, bolezni;
URN:	URN:NBN:SI
Source comment:	BSDOCID112284;
Pages:	str. 339-347
Volume:	ǂLetn. ǂ38
Issue:	ǂšt. ǂ4
Chronology:	2004
ID:	22859834