Dorsal Herniation of Cauda Equina Due to Sequestrated Intradural Disc

Singh, Pradeep K; Shrivastava, Sandeep; Dulani, Rajesh; Banode, Pankaj; Gupta, Sharad

doi:10.4184/asj.2012.6.2.145

Cited by 8 publications

(5 citation statements)

References 8 publications

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“…The symptoms of ILDH are atypical and complex, including low back pain, radiation pain, or lower extremity weakness, which is more serious than epidural disc herniation. Moreover, the incidence of CES in ILDH is higher than extradural lumbar disc herniation (2).…”

Section: Discussionmentioning

confidence: 91%

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Intradural lumbar disc herniation of L2–L3: A case report and literature review

2023

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BackgroundIntradural lumbar disc herniation (ILDH), especially upper lumbar intradural disc herniation, is a rare type of lumbar disc herniation (LDH). However, it may have severe and complex symptoms, causing serious impact on the patients. Additionally, it is difficult to be diagnosed with limited experience. Few studies on L2–L3 ILDH have been reported in the literature. This study presents such a case and reviews the incidence, etiology, symptoms, diagnosis and treatment of this disease, so as to provide guidance and experience for clinicians.Case presentationA 27-year-old male patient had a one-month history of severe lower back pain and left lower extremity weakness after lumbar sprain. He could not walk due to progressive symptoms. Physical examination revealed that straight leg raising and femoral nerve stretch tests on the left side were positive. Magnetic resonance imaging of lumbar showed an intradural disc protruding into the ventral dural sac at the L2–L3 level. He was diagnosed ILDH of L2–L3, finally. An urgent operation was performed to remove the intradural disc fragment. The patient's symptoms improved significantly, postoperatively. After eight months of follow-up, he returned to normal life with only slight lower back pain.ConclusionsILDH at the L2–L3 level is an extremely rare type of LDH. Its diagnosis often requires a combination of symptom, physical examination, and imaging examination due to no typical symptoms or imaging features. A detailed preoperative plan including the definition of the position, calcification, migration, and adhesion of intradural intervertebral discs to decrease the risk of surgery, prevent the occurrence of complications, and promote postoperative prognosis of patients.

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Section: Discussionmentioning

confidence: 91%

“…For ILDH, there are atypical and complex symptoms, such as low back pain, radiation pain, or lower extremity weakness. More seriously, ILDH may cause cauda equina syndrome (CES) (2). Prompt surgery is used in the treatment of ILDH, so as to alleviate severe symptoms, avoid aggravation of the condition, and prevent adverse events.…”

Section: Introductionmentioning

confidence: 99%

Intradural lumbar disc herniation of L2–L3: A case report and literature review

2023

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“…4 , 5 To our knowledge, so far no case of intradural disk herniation has been reported in a patient over the age of 75. 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 This may well account to the fact that intradural disk herniation is a rare event in general with approximately150 reported cases in the literature so far. 2 However, due to the ongoing demographic shift, more and more elderly patients will demand spinal surgery and, as our case report demonstrates, intradural disk herniation has to be considered as a differential diagnosis even in the aging population.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the first report of lumbar intradural disk herniation in a patient over the age of 75. 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16…”

Section: Introductionmentioning

confidence: 99%

Against the Odds: Massive Lumbar Intradural Disk Herniation in the Elderly

Orakcioglu

Trong

Jungk

et al. 2015

Global Spine Journal

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Study Design Case report. Objective Presentation of an unusual case of an elderly patient with massive intradural disk herniation at the L2–L3 level. Methods Clinical and imaging data are presented after obtaining informed consent from the patient. Results A 90-year-old man suffering from sudden-onset neurogenic bladder dysfunction and lower back pain but no further neurologic deficits initially presented with magnetic resonance imaging and laboratory values suggestive of an intraspinal infection. However, intraoperative inspection proved the unexpected finding of a large intradural lumbar disk herniation at the L2–L3 level. Conclusions Lumbar soft disk herniation to the intradural space is a rare event and has never been described in a patient over the age of 75. This case of a 90-year-old man with acute-onset bladder dysfunction underlines the necessity to consider this as a differential diagnosis in the case of a newly diagnosed intradural mass.

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“…Intradural disc herniation (IDH) is a rare disease and its incidence is reported as 0.26-0.30% of all disc herniations 16) . Approximately 92% of all IDHs occur in the lower lumbar spine 5 , 11) .…”

Section: Introductionmentioning

confidence: 99%

Traumatic Intradural Lumbar Disc Herniation without Bone Injury

Lee

Kwon

2013

Korean J Spine

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Intradural lumbar disc herniation is a rare disease. According to the reports of intradural lumbar disc herniations, most cases have developed as a chronic degenerative disc diseases. Traumatic intradural lumbar disc herniations are even rarer. A 52-year-old man visited our emergency center with numbness in his left calf and ankle after falling accident. Initial impression by radiologic findings was a spinal subdural hematoma at the L1 level. A follow up image two weeks later, however, did not demonstrate any interval change. The patient was decided to have an operation. In operative findings, a ruptured disc particle penetrating the ventral and dorsal dura was indentified after laminectomy. It was assumed to be a traumatic outcome not a degenerative change.

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Dorsal Herniation of Cauda Equina Due to Sequestrated Intradural Disc

Cited by 8 publications

References 8 publications

Intradural lumbar disc herniation of L2–L3: A case report and literature review

Intradural lumbar disc herniation of L2–L3: A case report and literature review

Against the Odds: Massive Lumbar Intradural Disk Herniation in the Elderly

Traumatic Intradural Lumbar Disc Herniation without Bone Injury

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