J Korean Neurosurg Soc.  2017 Feb;60(2):269-272. 10.3340/jkns.2014.1112.008.

An Intradiscal Granuloma Due to a Retained Wooden Foreign Body

Affiliations
  • 1Department of Neurosurgery, Inonu University School of Medicine, Medical Faculty, Malatya, Turkey. marifaladag@hotmail.com

Abstract

We report a patient with a wooden foreign body granuloma in the intervertebral disc space being symptomatic 17 years after a paraspinal penetrant trauma. According to the our result of the search for wooden foreign body granulomas, this is the first case suffered from a wooden foreign body granuloma in the intervertebral disc space that reported in the literature. In this report, we emphasized the importance of rigorous examination and follow up in paraspinal wooden penetrant traumas.

Keyword

Spinal injuries; Intervertebral disc; Granuloma; Foreign-body

MeSH Terms

Follow-Up Studies
Foreign Bodies*
Granuloma*
Granuloma, Foreign-Body
Humans
Intervertebral Disc
Spinal Injuries

Figure

  • Fig. 1 Clinical appearance of bad-healed scar on left lower back.

  • Fig. 2 Axial CT slice at the level according to L4 vertebral upper end plate. It is seen a hypodense lesion surrounding a linear hyperdense structure in the vertebral corpus. CT: computed tomography.

  • Fig. 3 A: Sagittal T1-weighted MRI image of lumbar spine demonstrated the fusion of anterior parts of L3 and L4 vertebral bodies and a hypointense lesion that lodged in posterior parts of disc space between these vertebrae. The lesion also expanded into the corpuses of these vertebrae. B: Sagittal T2-weighted MRI image of lumbar spine. The lesion was seen as hyperintense. C: Sagittal STIR sequence MRI image of lumbar spine. The lesion was seen as hyperintense. It is also seen a linear horizontal area of decreased signal intensity representing the intranuclear cleft in the center of posterior pars of disc space. D: Axial T1 weighted MRI image of lumbar spine at the level according to L4 vertebral upper end plate.

  • Fig. 4 A: Sagittal postcontrast T1-weighted image of lumbar vertebrae. A nodular enhancement around the peripheral areas of the lesion is seen. B: Axial postcontrast T1-weighted image. A marked enhancement around the peripheral areas of the lesion is seen.

  • Fig. 5 The wooden foreign body removed from posterior part of disc space between fourth and ÿfth lumbar vertebrae.

  • Fig. 6 The photomicrograph of wooden foreign body (H&E ×200).

  • Fig. 7 Histopathological appearance of inflammatory granulation tissue surrounding the foreign body (H&E ×200).


Reference

References

1. Bouajina E, Harzallah L, Ghannouchi M, Hamdi I, Rammeh N, Ben Hamida R, et al. Foreign body granuloma due to unsuspected wooden splinter. Joint Bone Spine. 73:329–331. 2006.
Article
2. Conway JE, Crofford TW, Terry AF, Protzman RR. Cauda equina syndrome occurring nine years after a gunshot injury to the spine. A case report. J Bone Joint Surg Am. 75:760–763. 1993.
Article
3. Daniel EF, Smith GW. Foreign-body granuloma of intervertebral disc and spinal canal. J Neurosurg. 17:480–482. 1960.
Article
4. El Bouchti I, Ait Essi F, Abkari I, Latifi M, El Hassani S. Foreign body granuloma: a diagnosis not to forget. Case Rep Orthop. 2012:439836. 2012.
Article
5. Grogan DP, Bucholz RW. Acute lead intoxication from a bullet in an intervertebral disc space. A case report. J Bone Joint Surg Am. 63:1180–1182. 1981.
Article
6. Key JA. Foreign body arthritis. Surg Gynec Obstet. 70:897–902. 1940.
7. Kuijlen JM, Herpers MJ, Beuls EA. Neurogenic claudication, a delayed complication of a retained bullet. Spine (Phila Pa 1976). 22:910–914. 1997.
Article
8. Lunawat SK, Taneja DK. A foreign body in the spinal canal. A case report. J Bone Joint Surg Br. 82:267–268. 2000.
9. Peterson JJ, Bancroft LW, Kransdorf MJ. Wooden foreign bodies: imaging appearance. AJR Am J Roentgenol. 178:557–562. 2002.
10. Seroyer RN, Fortson CH, Theodotou CB. Delayed neurological sequelae of a retained foreign body (lead bullet) in the intervertebral disc space. J Bone Joint Surg Am. 42-A:595–599. 1960.
11. Yoshioka K, Kawahara N, Murakami H, Demura S, Matsuda M, Tomita K. A glass foreign body migrating into the lumbar spinal canal: a case report. J Orthop Surg (Hong Kong). 20:257–259. 2012.
Article
Full Text Links
  • JKNS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr