我們提出一位44歲的男性病人被診斷出因頸椎椎間盤突出而造成Brown-Sequard syndrome。他的症狀包括左側肢體無力及右側頸椎第四皮節以下痛覺及溫度覺降低,核磁共振影像顯示在頸椎第三、四節間有一個很大的椎間盤突出壓迫左側脊髓。病人接受前位椎間盤切除、頸椎支架及人工骨椎體間融合手術後,運動及感覺功能恢復正常。因椎間盤突出造成之Brown-Sequard syndrome不易診斷,其特徵包括:1)脊髓壓迫位置數節以下之對側痛覺及溫度覺降低,2)椎間盤突出合併脊椎狹窄。由頸椎椎間假突出造成之Brown-Sequard syndrome不易診斷,我們建議及早手術治療。
Brown-Sequard syndrome caused by a herniated cervical disc is rare. We report a 44-year-old male patient who presented with left limb weakness and diminished sensation to pain and temperature on his right side below the C4 dermatome. A large protruding disc on the left side of the C3-4 disc space with cord compression was present on MRI. Brown-Sequard syndrome caused by herniated cervical disc was diagnosed. The patient underwent microdiscectomy and anterior cervical fusion by polyetheretherketone (PEEK) cage containing a core of biphasic calcium phosphate ceramic (triosite). Postoperatively, motor and sensory function returned to normal. Characteristic findings of discogenic Brown-Sequard syndrome are 1) contralateral deficit in sensation of pain and temperature of more than a few levels below the level of cord compression and 2) paracentral protrusion of the disc with cervical spinal stenosis. Early surgical intervention is always recommended.