UNCOMMON TYPES OF DISC HERNIA ( A REPORT OF THREE CASES AND REVIEW OF LITERATURE)
Background : Spinal disc hernia is prolapse of nucleus pulposus through a defect in annulus fibrosus. Over 90% of cases occur in the lumbar spine with only 1% being thoracic. Sequestered disc hernia is the last spectrum of progression of disc hernia with formation of mobile free fragment. Aim : To add to literature documentation of uncommon types of disc hernia Case Reports : CASE 1 : A 63year old Cameroonian man with L4/L5 sequestered disc hernia, seen posterior to L5 vertebral body. He had discectomy and symptomatic reliefs were better than pre-operative status conforming to McCulloch’s clinical outcome grade 3. CASE 2 : A 34year old male Cameroonian with chronic back pain and paraesthesia following trauma. Thoracic spine Magnetic resonance imaging (MRI) revealed T11/T12 disc hernia with severe epidural compression. He declined discectomy for an Overseas treatment. CASE 3 : A 72year old male Nigerian who had L3/L4 iatrogenic spinal fusion 5years ago. Lumbo-sacral spine MRI following recurrent low back pain showed L2/L3 and L4/L5 disc hernias. The L2/L3 hernia above the bony ankylosis interestingly is severer than L4/L5 hernia. He was managed conservatively. Conclusion : MRI increasing availability in Central Africa will detect more cases of uncommon types of disc hernias.
