Clinical Presentation, Diagnosis, and Surgical Treatment of Spontaneous Cervical Intradural Disc Herniations: A Review of the Literature

Cervical Intradural Disc Herniation: Case Report and Operative Video

“…In contrast, lumbar and thoracic spine IDH cases comprise 92% and 5%, respectively [1]. The most common locations of CIDH found in systematic reviews include C5-6 (35.1%-43.5%), the level involved in our patient C6-7 (24.3%-30.4%), C4-5 (13%), and C3-4 (13%) [1,2]. Increased number of cases seen at the lower cervical spine is thought to be related to the high tension on the posterior longitudinal ligament (PLL) from neck movement at this level [2].…”

“…We present such a case with an accompanying microsurgical video. Intradural disc herniations (IDHs) comprise less than 0.3% of all disc sequestrations, and cervical lesions comprise only 3% of all intradural herniation cases [1,2]. In contrast, lumbar and thoracic spine IDH cases comprise 92% and 5%, respectively [1].…”

Combined Posterior and Anterior Approaches for Cervical Intradural Disc Herniation: A Case Report

“…Pan et al state that anterior decompression leads to a better outcome since the posterior approach makes it hard to achieve complete decompression [7]. However, Arunprasad Gunasekaran et al [2] advocate that the posterior approach along with the separation of the denticulate ligament and a gentle mobilization of the cord results in a successful outcome. In this case, we chose the posterior approach, allowing the preservation of C5 vertebral body.…”

“…The pathophysiology of the IDH is still unclear and thought to be connected to chronic inflammation of the PLL and the PLL adhered to dura. Once the disc herniated, disc fragment goes through both PLL and dura due to the adhesion [2,7].…”

“…I ntradural disc herniation (IDH) is an extremely rare condition, comprising less than 0.27% of all disc herniation cases. In the cervical spine, it accounts for only 3% of IDH (as most occur in the lumbar spine [1]) and there are 37 cervical IDH cases reported in literature [2]. Here, we present a case of cervical IDH along with a review of its radiological characteristics.…”