T1-T2 disc herniation: Report of four cases and review of the literature

Horner’s syndrome secondary to T1-T2 intervertebral disc prolapse

Background:

T1-T2 intervertebral disc prolapse (IVDP) is a rare clinical condition. Horner’s syndrome is an extremely rare clinical finding in these patients.

Case Description:

A 56-year-old man presented with the left C8 T1 radiculopathy, left hand grip weakness, and ipsilateral Horner’s syndrome. Magnetic resonance imaging of the spine showed a contrast-enhancing lesion in the left T1 foramen compressing the left T1 nerve root. He underwent left T1 hemilaminectomy, upper half of left T2 hemilaminectomy and removal of the left foraminal lesion. A biopsy of the lesion was sent for histopathological diagnosis which revealed tissue consistent with disc material. Postoperatively, he had near-complete recovery with residual minimal Horner’s syndrome.

Conclusion:

T1-T2 IVDP should be considered in the differential diagnosis when a patient presents with C8 T1 radiculopathy and Horner’s syndrome.

Acute traumatic sequestrated thoracic disc herniation: A case report and review

Background:

Pure sequestrated thoracic disc herniations secondary to a traumatic event are rare.

Case Description:

Elderly male presented with the sudden onset of severe paraparesis following a fall. The MR showed a left-sided extruded disc at the T10-T11. The patient underwent a thoracic interlaminar laminectomy, removal of one large, and several smaller sequestrated disc fragments utilizing a transfacet corridor requiring placement of an interbody Peek cage, and bilateral T10 and T11 pedicle screw instrumentation. At 6 postoperative months, he sustained a good recovery.

Conclusion:

Acute thoracic disc herniations without attendant fracture/dislocation are rare. When they result in major neurological deficits, timely surgical excision is warranted.