Hérnias discais dorso-lumbares e síndrome da cauda equina como complicações da doença de Scheuermann: relato de caso

Brito-Marques, Paulo Roberto de

doi:10.1590/S0004-282X1994000300027

Resumos

É descrito o caso de um paciente com compressão medular por hérnia discal torácica sem paraplegia e síndrome da cauda equina por lesões espondilodiscais, com pequenas protrusões em L4-L5 e L5-S1, associadas à doença de Scheuermann. O paciente recuperou-se com tratamento clínico em seis meses. O estudo radiológico do caso com radiografias simples, mielografia, tomografia computadorizada e ressonância magnética da coluna vertebral e o estudo eletroneuromiográfico indica haver correspondência precisa entre o quadro clínico e as degenerações ósteo-disco-ligamentosas da coluna lombar com as raízes espinhais afetadas e hérnias lombares, assim como as seqüelas ósseas da distrofia raquídea da doença de Scheuermann.

coluna vertebral; hérnia discai; doença de Scheuermann

The author reports the case of a patient with spinal cord compression by a thoracic herniated disc without paraplegia as well as a cauda equina syndrome due to spondylotic and discai lesions, with small protrusions of the L4-L5 and L5-S1 discs associated with Scheuermann disease. There was complete recovery in six months with clinical treatment. The radiological evaluation using standard radiography, myelography, computed tomography, magnetic resonance imaging of the vertebral column, and electromyographic evaluation indicate a precise correlation between clinical picture and the distribution and course of lumbar spinal cord degenerations. Furthermore, a strong correlation was also found with hernias, roots and the bony sequalae of spinal cord dystrophy found in Scheuermann disease.

spine; disc herniation; Scheuermann disease

Hérnias discais dorso-lumbares e síndrome da cauda equina como complicações da doença de Scheuermann: relato de caso

Thoracic lumbar herniated disc and cauda equina syndrome as complications of Scheuermann disease: a case report

Paulo Roberto de Brito-Marques

Disciplina de Neurologia do Departamento de Medicina Clínica da Faculdade de Ciências Médicas da Universidade de Pernambuco

RESUMO

É descrito o caso de um paciente com compressão medular por hérnia discal torácica sem paraplegia e síndrome da cauda equina por lesões espondilodiscais, com pequenas protrusões em L4-L5 e L5-S1, associadas à doença de Scheuermann. O paciente recuperou-se com tratamento clínico em seis meses. O estudo radiológico do caso com radiografias simples, mielografia, tomografia computadorizada e ressonância magnética da coluna vertebral e o estudo eletroneuromiográfico indica haver correspondência precisa entre o quadro clínico e as degenerações ósteo-disco-ligamentosas da coluna lombar com as raízes espinhais afetadas e hérnias lombares, assim como as seqüelas ósseas da distrofia raquídea da doença de Scheuermann.

Palavras-chave: coluna vertebral, hérnia discai, doença de Scheuermann.

SUMMARY

The author reports the case of a patient with spinal cord compression by a thoracic herniated disc without paraplegia as well as a cauda equina syndrome due to spondylotic and discai lesions, with small protrusions of the L4-L5 and L5-S1 discs associated with Scheuermann disease. There was complete recovery in six months with clinical treatment. The radiological evaluation using standard radiography, myelography, computed tomography, magnetic resonance imaging of the vertebral column, and electromyographic evaluation indicate a precise correlation between clinical picture and the distribution and course of lumbar spinal cord degenerations. Furthermore, a strong correlation was also found with hernias, roots and the bony sequalae of spinal cord dystrophy found in Scheuermann disease.

Key words: spine, disc herniation, Scheuermann disease.

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Aceite: 18-dezembro-1993.

Dr. Paulo Roberto de Brito Marques - Rua Santa Terezinha 58 - 53140-170 Olinda PE - Brasil.

1. Bouchez B, Arnott G, Combelles G, Pruvo JP. Compression médullaire par hernie discale dorsale: une complication de la maladie de Scheuermann. Rev Neurol (Paris) 1986, 142: 154-158.
2. Bradford D, Garcia A. Neurological complication in Scheuermann disease: a case report and review of the literature. J Bone Joint Surg 1969, 51-A: 567-572.
3. Dreyfus P, Six B, Dorfman H, de Seze S. La hernie discale dorsale. Sem Hôp Paris 1972, 48: 3045-3052.
4. Epstein BS. Afecciones de la columna vertebral y de la medula espinal. Ed 3. Barcelona: JIMS, 1981, p 617-622.
5. Lesoin F, Bouchez B, Rousseaux M, Villette L, Pruvo JP, Autrique A, Jomin M. Hernies discales dorsales et maladie de Scheuermann: six observations. Sem Hôp Paris 1986, 62: 91-94.
6. Lesoin F, Rousseaux M, Dubois F, Leys D, Pruvo JP, Petit H, Jomin M. Souffrance radiculo-médullaire et maladie de Scheuermann: 12 observations. Rev Med Interne 1987, 8: 39-46.
7. Lesoin F, Rousseaux M, Viaud C, Leys D, Prudo JP, Jomin M. Syndrome radiculo-médullaire au cours de la maladie de Scheuermann. Rev Rhumat 1985, 52: 57-59.
8. Normelli HCM, Svensson O, Aaro SI. Cord compression in Scheuermann's kyphosis: a case report. Acta Orthop Scand 1991, 62 (1): 70-72.
9. Milgrom C, Kaplan L, Liberti S, Robin GC. Femoral nerve neuropraxia secondary to repetitive trauma in a patient with juvenile lumbar osteochondrosis: differential diagnosis of an osteolytic lesion with a neurologic deficit. Report of a case. Clin Orthop Rel Res 1984, 190: 135-137.
10. Ryan MD, Taylor TKF. Acute spinal cord compression in Scheuermann's disease. J Bone Joint Surg 1982, 64-B: 409-412.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Set 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bouchez B, Arnott G, Combelles G, Pruvo JP. Compression médullaire par hernie discale dorsale: une complication de la maladie de Scheuermann. Rev Neurol (Paris) 1986, 142: 154-158.

[2] 2. Bradford D, Garcia A. Neurological complication in Scheuermann disease: a case report and review of the literature. J Bone Joint Surg 1969, 51-A: 567-572.

[3] 3. Dreyfus P, Six B, Dorfman H, de Seze S. La hernie discale dorsale. Sem Hôp Paris 1972, 48: 3045-3052.

[4] 4. Epstein BS. Afecciones de la columna vertebral y de la medula espinal. Ed 3. Barcelona: JIMS, 1981, p 617-622.

[5] 5. Lesoin F, Bouchez B, Rousseaux M, Villette L, Pruvo JP, Autrique A, Jomin M. Hernies discales dorsales et maladie de Scheuermann: six observations. Sem Hôp Paris 1986, 62: 91-94.

[6] 6. Lesoin F, Rousseaux M, Dubois F, Leys D, Pruvo JP, Petit H, Jomin M. Souffrance radiculo-médullaire et maladie de Scheuermann: 12 observations. Rev Med Interne 1987, 8: 39-46.

[7] 7. Lesoin F, Rousseaux M, Viaud C, Leys D, Prudo JP, Jomin M. Syndrome radiculo-médullaire au cours de la maladie de Scheuermann. Rev Rhumat 1985, 52: 57-59.

[8] 8. Normelli HCM, Svensson O, Aaro SI. Cord compression in Scheuermann's kyphosis: a case report. Acta Orthop Scand 1991, 62 (1): 70-72.

[9] 9. Milgrom C, Kaplan L, Liberti S, Robin GC. Femoral nerve neuropraxia secondary to repetitive trauma in a patient with juvenile lumbar osteochondrosis: differential diagnosis of an osteolytic lesion with a neurologic deficit. Report of a case. Clin Orthop Rel Res 1984, 190: 135-137.

[10] 10. Ryan MD, Taylor TKF. Acute spinal cord compression in Scheuermann's disease. J Bone Joint Surg 1982, 64-B: 409-412.