Thoracic Disc Herniation Manifesting as Abdominal Pain Alone Associated with Thoracic Radiculopathy

Motonori Ishii; Yusuke Nishimura; Masahito Hara; Kaoru Eguchi; Yoshitaka Nagashima; Takayuki Awaya; Ryo Ando; Shoichi Haimoto; Toshihiko Wakabayashi

doi:10.2176/nmccrj.cr.2019-0247

Thoracic Disc Herniation Manifesting as Abdominal Pain Alone Associated with Thoracic Radiculopathy

NMC Case Rep J. 2020 Sep 15;7(4):161-165. doi: 10.2176/nmccrj.cr.2019-0247. eCollection 2020 Sep.

Authors

Motonori Ishii¹, Yusuke Nishimura¹, Masahito Hara², Kaoru Eguchi¹, Yoshitaka Nagashima¹, Takayuki Awaya¹, Ryo Ando¹, Shoichi Haimoto¹, Toshihiko Wakabayashi¹

Affiliations

¹ Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan.
² Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi, Japan.

Abstract

Symptomatic thoracic disc herniation (TDH) with thoracic radiculopathy alone is an extremely rare condition. Here, we report a rare case of TDH in a 52-year-old man who presented with medically refractory severe right flank pain. Based on pain distribution, pain intensity changes according to truncal position, ineffectiveness of intercostal nerve block, and radiological findings, his pain was determined to be caused by TDH at T9-10 level. Symptomatic TDH often requires invasive surgery. However, TDH with radiculopathy alone can be treated via a posterior approach without spinal cord manipulation or spinal fusion. We could eliminate the pain by removing TDH with hemilaminectomy and microdiscectomy using an O-arm-based navigation system.

Keywords: abdominal wall pain; intercostal neuralgia; posterior approach; thoracic disc herniation; thoracic radiculopathy.

Publication types

Case Reports