Lumbar intervertebral disc calcification in adult

¹Department of Neurosurgery. Avicenne Military Hospital of Marrakech, Marrakech, Morocco, ²Mohammed V University in Rabat, Rabat, Morocco

^&Corresponding author
Ali Akhaddar, Department of Neurosurgery. Avicenne Military Hospital of Marrakech, Marrakech, Morocco

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Intervertebral disc calcification (IVDC) is a rare cause of spinal pain. Both children and adults can be involved, however this affection is more common in cervical and thoracic spine than lumbar column. A 52-year-old man, previously healthy, presented with an acute lumbalgia. He complained of spontaneous low back pain for more than 4 months, aggravated for the last few weeks. He denied any history of injury, important change in weight, systemic disease or recent episodes of fever. Physical examination revealed limitation in low back movements with paraspinal muscle spasm. Straight leg test and tendon reflexes were normal without any neurologic deficits. Computed tomography scan (A, B, C) showed an unusual homogenous, well limited, calcified lesion at the L4-L5 intervertebral level (arrows) with a straightness of the lumbar spine. The calcified structure rather corresponds to the nucleus pulposus: the central portion of intervertebral disc. Laboratory finding showed no inflammatory sign. The patient was treated with rest, analgesic and anti-inflammatory agents. Symptoms resolved few weeks later. The etiology of IVDC still remains uncertain and in most adult patients, this phenomenon is known as an idiopathic rare condition. The majority of cases are pauci or asymptomatic. Calcification in children is usually spontaneously resolved, unlike in adults in whom calcified deposits in discs are rather permanent. As seen in our patient, most symptomatic cases are treated conservatively with an excellent prognosis. Rarely, the calcified discs may occasionally lead to nerve root or spinal cord compression. Thus, neurosurgical decompression with excision can be planned.

Figure 1: lumbar intervertebral disc calcification in adult