Bilateral thoracic disc herniation with abdominal wall paresis: a case report

Abstract

We present a rare case of a patient initially presenting with unilateral abdominal wall bulging and radicular pain caused by a lateral disc herniation at Th11/12, later suffering from a hernia recurrence with bilateral disc prolapse and motor deficits. The patient underwent sequesterectomy via a right hemilaminectomy at Th11, and after 8 weeks, a bilateral sequesterectomy with semirigid fusion Th11/12 was performed. Unilateral motor deficits at the thoracic level have been discussed in case reports; a bilateral disc protrusion with abdominal wall bulging occurring as a recurrent disc herniation has never been described before.

Keywords: Disc herniation; Motor deficit; Thoracic spine.

Fig. 1

Initial presentation of the patient with abdominal wall bulging right-sided

Fig. 2

The abdominal CT scan excludes the suspected diagnosis of an abdominal wall herniation

Fig. 3

The MRI scan of the thoracolumbar spine T2 weighted axial and sagittal presents a right-sided disc herniation TH 11/12

Fig. 4

In the clinical follow-up 8 weeks after the first operation, the patient presented with bilateral abdominal wall bulging

Fig. 5

MRI of the thoracolumbar spine T2 weighted 8 weeks after initial presentation with clinical bilateral thoracic abdominal wall bulging and a bilateral relapse of disc herniation Th11/12

Fig. 6

Intraoperative findings: A discectomy (a) and dynamic fusion (b) was performed

Fig. 7

Postoperative X-ray in lateral (a) and anterior-posterior imaging (b)