International Clinical Neuroscience Journal

Vol. 10 No. 1 (2023)

Difficulties in Diagnosis and Operation Associated With Lumbar Intradural Disc Herniation: A Case Report Lumbar intradural disc herniation

International Clinical Neuroscience Journal, Vol. 10 No. 1 (2023), 15 January 2023 , Page e13

Abstract

Intradural disk herniation (IDH) represents an uncommon instance of disk degeneration. The surgical treatment of IDH,
preoperative, and intraoperative diagnosis are difficult. The present case report highlights the difficult parts of diagnosis and surgery.
A 44-year-old man presented with lower back pain radiating to his right leg. A disk protruding into the ventral dural sac and
exhibiting the hawk-beak sign was discovered by MRI. The dorsal side was exposed and incised during L3/4 laminectomy, a
puncture on the ventral side was detected, and subsequently, three fragments extending into the dura sac were discovered. The
defect was corrected and completed internal fixing was done. Pathology identified it as nucleus pulposus tissue. At one-month
follow-up, he was able to walk normally. An incredibly uncommon form of disc degeneration is lumbar IDH. MRI can assist in
the diagnosis, however, surgical investigation and pathology are necessary for an accurate diagnosis.

Keywords:
  • Intradural disc herniation
  • Lower back pain
  • Radiating pain
  • Laminectomy
  • Ventral dural sac

How to Cite

1.
T. Le H, Dinh H, H.T. Pham Q, D. Tran H, T. Nguyen M. Difficulties in Diagnosis and Operation Associated With Lumbar Intradural Disc Herniation: A Case Report: Lumbar intradural disc herniation. Int Clin Neurosci J [Internet]. 2023 Nov. 23 [cited 2024 Sep. 12];10(1):e13. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/43132

References

Kataoka O, Nishibayashi Y, Sho T. Intradural lumbar disc herniation. Report of three cases with a review of the literature. Spine (Phila Pa 1976). 1989;14(5):529-33.

Arnold PM, Wakwaya YT. Intradural disk herniation at L1-L2: report of two cases. J Spinal Cord Med. 2011;34(3):312-4.

D'Andrea G, Trillò G, Roperto R, Celli P, Orlando ER, Ferrante L. Intradural lumbar disc herniations: the role of MRI in preoperative diagnosis and review of the literature. Neurosurg Rev. 2004;27(2):75-80; discussion 1-2.

DANDY WE. Serious complications of ruptured intervertebral disks. Journal of the American Medical Association. 1942;119(6):474-7.

Oztürk A, Avci E, Yazgan P, Torun F, Yücetaş S, Karabağ H. Intradural herniation of intervertebral disc at the level of Lumbar 1-Lumbar 2. Turk Neurosurg. 2007;17(2):134-7.

Kim HS, Eun JP, Park JS. Intradural migration of a sequestrated lumbar disc fragment masquerading as a spinal intradural tumor. J Korean Neurosurg Soc. 2012;52(2):156-8.

Pedaballe AR, Mallepally AR, Tandon V, Sharma A, Chhabra HS. An Unusual Case of Transdural Herniation of a Lumbar Intervertebral Disc: Diagnostic and Surgical Challenges. World Neurosurg. 2019;128:385-9.

Moon SJ, Han MS, Lee GJ, Lee SK, Moon BJ, Lee JK. Unexpected Intradural Lumbar Disk Herniation Found During Transforaminal Endoscopic Surgery. World Neurosurg. 2020;134:540-3.

Yildizhan A, Paşaoğlu A, Okten T, Ekinci N, Aycan K, Aral O. Intradural disc herniations pathogenesis, clinical picture, diagnosis and treatment. Acta Neurochir (Wien). 1991;110(3-4):160-5.

Fiorenza V, Ascanio F, Di Lorenzo I. Clinicopathologic Features of Thoracolumbar Interdural Disc Herniations: A Retrospective Case Series with a Systematic Literature Review. World Neurosurg. 2020;139:e391-e8.

Theodorou DJ, Theodorou SJ, Kakitsubata Y, Papanastasiou EI, Gelalis ID. Posterior and anterior epidural and intradural migration of the sequestered intervertebral disc: Three cases and review of the literature. J Spinal Cord Med. 2022;45(2):305-10.

Ponzo G, Furnari M, Umana GE, Giuffrida M, Nicoletti GF, Scalia G. Intradural lumbar disc herniations at the L1-L2 level: A case study and literature review. Surg Neurol Int. 2020;11:67.

Chen J, Ni HJ, Xue F, Fan YS, Li XF, Chen XZ, et al. Upper Lumbar Intradural Disc Herniation: A Rare Case Report and Etiologic Analysis. J Pain Res. 2021;14:1475-81.

Thohar Arifin M, Ikbar KN, Brilliantika SP, Bakhtiar Y, Bunyamin J, Muttaqin Z. Challenges in intradural disc herniation diagnosis and surgery: A case report. Ann Med Surg (Lond). 2020;58:156-9.

Tamaki Y, Sakai T, Miyagi R, Nakagawa T, Shimakawa T, Sairyo K, et al. Intradural lumbar disc herniation after percutaneous endoscopic lumbar discectomy: case report. J Neurosurg Spine. 2015;23(3):336-9.

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