Turkish Neurosurgery
2013 , Vol 23 , Num 3
Intradural Disc Herniation - A Case Report
S.M.S Medical College and Hospital, Department of Neurosurgery, Jaipur, India
DOI :
10.5137/1019-5149.JTN.5437-11.1
Intradural disc herniation is a rare entity that occurs most commonly in the lumbar spine particularly at L4-L5 region. Most often it is diagnosed
intraoperatively in a case of simple intervertebral disc herniation. Contrast enhanced MRI is mandatory for pre operative diagnosis. We describe
a case of a 40-year-old female who presented to us with pain lower back, pain in both lower limbs and urinary retention after a fall. She had
previously been diagnosed as a case of prolapsed intervertebral disc disease and was being managed conservatively. An unenhanced MRI
revealed a large disc herniation at L4-L5 level. L4 and L5 laminectomy was performed and a hard intradural mass was palpable. On opening
the dura a fragment of intervertebral disc was found with a small rent in the anterior dura. The fragment was removed and the rent was
sutured. The patient recovered well from the surgery. Intradural disc herniations must be considered in the differential diagnosis of prolapsed
intervertebral disc disease especially with recent worsening of symptoms and mismatch of unenhanced MRI findings with intraoperative
findings.
Keywords :
Intradural disc, Diagnosis, L4-L5 level, Lumbar disc