RESUMEN
OBJECTIVE: To present a radiculopathy case due to unilateral facet hypertrophy developing three years after a lumbar disc hernia operation. CASE REPORT: A fifty two-year-old female patient, who had been operated on for a left L5-S1 herniated lumbar disc three years ago, was hospitalized and re-operated with a diagnosis of unilateral facet hypertrophy. She had complaints of left leg pain and walking restrictions for the last six months. Left Straight Leg Raising test was positive at 40 degrees , left ankle dorsiflexion muscle strength was 4/5, left Extensor Hallucis Longus muscle strength was 3/5, and left Achilles reflex was hypoactive. Lumbar spinal Magnetic Resonance Imaging revealed left L5-S1 facet hypertrophy. RESULTS AND CONCLUSIONS: Lumbar radiculopathy due to lumbar facet hypertrophy is a well-known neurological condition. Radicular pain develops during the late postoperative period following lumbar disc hernia operations that are often related to recurrent disc herniation or to formation of post-operative scar tissue. In addition, it can be speculated that unilateral facet hypertrophy, which may develop after a disc hernia operation, might also be one of the causes of radiculopathy.
Asunto(s)
Desplazamiento del Disco Intervertebral/cirugía , Procedimientos Neuroquirúrgicos , Complicaciones Posoperatorias/patología , Radiculopatía/etiología , Radiculopatía/patología , Articulación Cigapofisaria/patología , Discectomía , Femenino , Humanos , Hipertrofia , Dolor de la Región Lumbar/etiología , Región Lumbosacra , Imagen por Resonancia Magnética , Persona de Mediana Edad , Columna Vertebral/patologíaRESUMEN
1-4% of osteochondromas involve the spine. They are commonly found in the posterior elements of the vertebra and can cause radicular symptoms. We report a 35 year-old man, suffering from right leg pain, which became worse over five years. His neurological examination revealed a positive right straight leg raising test and L4-L5 hypoesthesia. Lumbar computerised tomography (CT) and magnetic resonance imaging (MRI) studies revealed an exophytic, pedunculated bony projection. Osteochondroma should be considered while evaluating a patient with low back pain or radiculopathy without a CT or MRI appearance of a herniated lumbar disc.