Acute Onset Atypical Severe Scoliosis: A Case Report.
Acute Disease
Adolescent
Ambulatory Care Facilities
Diskectomy
/ methods
Follow-Up Studies
Humans
Intervertebral Disc Degeneration
/ complications
Intervertebral Disc Displacement
/ complications
Low Back Pain
/ diagnosis
Magnetic Resonance Imaging
/ methods
Male
Pain Measurement
Radiography, Thoracic
/ methods
Risk Assessment
Scoliosis
/ diagnostic imaging
Treatment Outcome
MRI
acute onset scoliosis
atypical scoliosis
discectomy
herniated nucleus pulposus
laminectomy
scoliosis
Journal
The Iowa orthopaedic journal
ISSN: 1555-1377
Titre abrégé: Iowa Orthop J
Pays: United States
ID NLM: 8908272
Informations de publication
Date de publication:
2019
2019
Historique:
entrez:
16
8
2019
pubmed:
16
8
2019
medline:
7
2
2020
Statut:
ppublish
Résumé
Although most cases of scoliosis are idiopathic, scoliosis may also be congenital or associated with other diseases. Herniated Nucleus Pulposus (HNP) has been reported as a potential cause of non-structural scoliosis. HNP is unusual in adolescents and the clinical features are typically different from those in adults. An 18-year-old Caucasian male was referred to our ambulatory service for evaluation of scoliosis after orthopedic evaluation at another center. He had noticed left-sided low back pain in the previous 6 months, which had worsened over the last two months with the development of limp and left lower extremity (LLE) paresthesias. After an accurate clinical evaluation, the acute onset of the curvature with mild back pain and associated neurological findings were suggestive of an intraspinal lesion. The MRI examination showed an L4-L5 HNP compressing L4 nerve root and displacing the distal L5 nerve root. An L4-L5 laminectomy and discectomy were performed. His left leg pain was completely relieved the day after surgery. At 3 months follow-up complete resolution of scoliosis deformity and return to full activity was achieved. Every child who presents with atypical scoliosis should have a complete physical examination and appropriate imaging studies seeking an underlying cause.
Sections du résumé
Background
Although most cases of scoliosis are idiopathic, scoliosis may also be congenital or associated with other diseases. Herniated Nucleus Pulposus (HNP) has been reported as a potential cause of non-structural scoliosis. HNP is unusual in adolescents and the clinical features are typically different from those in adults.
Case Presentation
An 18-year-old Caucasian male was referred to our ambulatory service for evaluation of scoliosis after orthopedic evaluation at another center. He had noticed left-sided low back pain in the previous 6 months, which had worsened over the last two months with the development of limp and left lower extremity (LLE) paresthesias. After an accurate clinical evaluation, the acute onset of the curvature with mild back pain and associated neurological findings were suggestive of an intraspinal lesion. The MRI examination showed an L4-L5 HNP compressing L4 nerve root and displacing the distal L5 nerve root. An L4-L5 laminectomy and discectomy were performed. His left leg pain was completely relieved the day after surgery. At 3 months follow-up complete resolution of scoliosis deformity and return to full activity was achieved.
Conclusions
Every child who presents with atypical scoliosis should have a complete physical examination and appropriate imaging studies seeking an underlying cause.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
85-88Déclaration de conflit d'intérêts
Disclosures: The authors report no potential conflicts of interest related to this study.
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