A rare cause of "foot drop": spinal epidural brucella granuloma.

Spinal epidural abscess is rare but serious medical condition which may cause permanent neurological deficits, or even death, if not treated. Staphylococcus aureus is the responsible microorganism in most spinal abscess cases. However, rarely other microorganisms like Brucella may be responsible. Brucellosis, a zoonotic infection endemic in the Mediterranean Region, Middle East; and South and Central America, most frequently involves the reticuloendothelial and musculoskeletal systems. Vertebral involvement is rarely seen; and its differential diagnosis is rather difficult. Spondylodiscitis and rarely spinal abscess or development of a granuloma are the main pathologies. Spinal epidural granulomas due to brucellosis may cause neurologic deficits. In this case presentation, a spinal epidural brucella granuloma causing foot drop is discussed taking other reports into account.

Lumbar radiculopathy due to unilateral facet hypertrophy following lumbar disc hernia operation: a case report.

OBJECTIVE: To present a radiculopathy case due to unilateral facet hypertrophy developing three years after a lumbar disc hernia operation. CASE REPORT: A fifty two-year-old female patient, who had been operated on for a left L5-S1 herniated lumbar disc three years ago, was hospitalized and re-operated with a diagnosis of unilateral facet hypertrophy. She had complaints of left leg pain and walking restrictions for the last six months. Left Straight Leg Raising test was positive at 40 degrees , left ankle dorsiflexion muscle strength was 4/5, left Extensor Hallucis Longus muscle strength was 3/5, and left Achilles reflex was hypoactive. Lumbar spinal Magnetic Resonance Imaging revealed left L5-S1 facet hypertrophy. RESULTS AND CONCLUSIONS: Lumbar radiculopathy due to lumbar facet hypertrophy is a well-known neurological condition. Radicular pain develops during the late postoperative period following lumbar disc hernia operations that are often related to recurrent disc herniation or to formation of post-operative scar tissue. In addition, it can be speculated that unilateral facet hypertrophy, which may develop after a disc hernia operation, might also be one of the causes of radiculopathy.