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

Case Reports

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

Author information

Motonori Ishii
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
Yusuke Nishimura
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
Masahito Hara
Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi, Japan
Kaoru Eguchi
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
Yoshitaka Nagashima
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
Takayuki Awaya
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
Ryo Ando
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
Shoichi Haimoto
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
Toshihiko Wakabayashi
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan

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

JOURNAL OPEN ACCESS FULL-TEXT HTML

2020 Volume 7 Issue 4 Pages 161-165

DOI https://doi.org/10.2176/nmccrj.cr.2019-0247

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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.

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