頸椎硬膜內椎間盤突出症及CT掃描硬膜內氣泡

Cervical Intradural Disc Herniation and Intradural Gas on CT Scan

已知文獻僅32例頸椎硬膜內椎間盤突出症，至今難以在術前明確診斷。本報告病人為55歲女性於運動後頸部疼痛，且轉移至雙肩及上臂，並雙手麻木無力。經MRI檢查顯示頸椎3-4節有後縱韌帶中斷及「鷹喙徵」椎間盤突出，在CT掃描發現頸椎3-4節椎間盤突出及椎管有氣泡的現象。曾有報告腰椎硬膜內椎間盤突出症有出現過CT掃描椎管有氣泡的現象，但是在頸椎椎管出現氣泡這現象本報告是第一例。病人經過椎間盤切除，硬膜修補及前融合術後預後良好。

Intradural disc herniation has been reported as a rare type of intervertebral disc herniation, only 32 cases reported. It remains difficult to definitively diagnose the disease before surgery. We reported a 55 year-old female patient complaints of nuchal pain and bilateral arm weakness after a trauma accident. MRI revealed a C3-C4 herniated intervertebral disc (HIVD) with a “hawk-beak sign.” CT scan image revealing two small gas bubbles in the spinal canal at C3-C4 level. In previous study, the presence of epidural gas on CT scan might suggest the potential presence of an intradural disc herniation in the lumbar spine. To our knowledge, this is the first case of cervical intradural herniated disc with intradural gas on CT scan.