Intradural lumbar disc herniation: A case report and literature review
Cheng-Hsin Cheng,
MD, PhD. Che-Chao Chang,
Hung-Lin Lin,
Hao-Yu Chuang,
Ruey-Mo Lin,
Ning-Ping Foo
Affiliations
Cheng-Hsin Cheng
Department of Neurosurgery, An Nan Hospital, China Medical University, 70965, Tainan, Taiwan; Graduate Institute of Medical Science, Chang Jung Christian University, Tainan, 71101, Taiwan
MD, PhD. Che-Chao Chang
Department of Neurosurgery, An Nan Hospital, China Medical University, 70965, Tainan, Taiwan; Neurophysiology Laboratory, Department of Surgery, National Cheng Kung University Medical Center and Medical School, 70101, Taiwan
Hung-Lin Lin
Department of Neurosurgery, China Medical University Hospital, Taichung, 40447, Taiwan
Hao-Yu Chuang
Department of Neurosurgery, An Nan Hospital, China Medical University, 70965, Tainan, Taiwan; Department of Neurosurgery, China Medical University Hospital, Taichung, 40447, Taiwan
Ruey-Mo Lin
Department of Orthopedics, An Nan Hospital, China Medical University, Tainan, 70101, Taiwan; Corresponding author.
Ning-Ping Foo
Graduate Institute of Medical Science, Chang Jung Christian University, Tainan, 71101, Taiwan; Department of Emergency Medicine, An Nan Hospital, China Medical University, Tainan 70965, Taiwan; Corresponding author.
Study design and objection: Intradural disc herniation is a unusual disease associated with spinal surgery. The definitive diagnosis of intradural herniation depends on intraoperative findings. Summary of background data: We present the case of a 63-year-old woman with backache and left sciatica radiation for more than two months. The L2/3 laminectomy and discectomy were performed after magnetic resonance imaging (MRI) study; however, no disc rupture was noted during surgery. Follow-up lumbar spine MRI revealed one large, ruptured disc. The patient underwent revision surgery with durotomy. The large intradural disc was found and removed piece by piece. Methods, Results, and Conclusions: Intradural disc herniation, especially large herniation, is hard to diagnose specifically despite the progression of neuroradiologic imaging techniques. A durotomy procedure should be considered if there is a missing ruptured disc or a palpable intradural mass during surgery.
