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

doi:10.1016/j.heliyon.2022.e12257

Intradural lumbar disc herniation: A case report and literature review

Heliyon. 2022 Dec 14;8(12):e12257. doi: 10.1016/j.heliyon.2022.e12257. eCollection 2022 Dec.

Authors

Cheng-Hsin Cheng^{1

2}, Md PhD Che-Chao Chang^{1

3}, Hung-Lin Lin⁴, Hao-Yu Chuang^{1

4}, Ruey-Mo Lin⁵, Ning-Ping Foo^{2

6}

Affiliations

¹ Department of Neurosurgery, An Nan Hospital, China Medical University, 70965, Tainan, Taiwan.
² Graduate Institute of Medical Science, Chang Jung Christian University, Tainan, 71101, Taiwan.
³ Neurophysiology Laboratory, Department of Surgery, National Cheng Kung University Medical Center and Medical School, 70101, Taiwan.
⁴ Department of Neurosurgery, China Medical University Hospital, Taichung, 40447, Taiwan.
⁵ Department of Orthopedics, An Nan Hospital, China Medical University, Tainan, 70101, Taiwan.
⁶ Department of Emergency Medicine, An Nan Hospital, China Medical University, Tainan 70965, Taiwan.

Abstract

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.

Keywords: Durotomy; Intervertebral disc disease; Intradural disc herniation; Low back pain; Sciatica.

Publication types

Review