Cervical intradural disc herniation, case report and reflection on preoperative imaging

Abstract

Intradural disc herniation in the cervical spine is a rare condition that requires identification and modification of surgical technique to avoid postoperative complications. A 55-year-old male with a C4-5 intradural disc herniation who presented with radicular symptoms was treated via anterior cervical discectomy and fusion. The dural defect was identified at the time of surgery. On retrospective review of the patient's preoperative MRI, there were subtle findings of the intradural disc location, including a surrounding ring of hyperintensity on T2 and less deformation of the spinal cord than would be expected given its size.

Intradural cervical herniated nucleus pulposus presentation and management: a case report

“…Choi et al ( 6 ) described 2 cases showing a focal defect in the posterior longitudinal ligament (PLL), and a triangular, central disc projection compressing the cord, which they designated a “hawk-beak sign”. Börm et al ( 7 ) and Celano et al ( 8 ) both found that the intradural disc was surrounded by a high signal intensity halo on T2-weighted imaging. Although not described by the authors, both the halo sign and a beak-like central projection are also present in a case reported by Baudracco et al ( 9 ).…”