Journal of Korean Neurosurgical Society

  • 제47권3호
  • /
  • Pages.217-220
  • /
  • 2010
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

Dorsal Extradural Lumbar Disc Herniation Causing Cauda Equina Syndrome : A Case Report and Review of Literature

  • Kim, Jin-Sung (Departments of Neurosurgery, Wooridul Spine Hospital) ;
  • Lee, Sang-Ho (Departments of Neurosurgery, Wooridul Spine Hospital) ;
  • Arbatti, Nikhil J. (Departments of Orthopedic Surgery, Wooridul Spine Hospital)
  • 투고 : 2009.05.06
  • 심사 : 2010.01.06
  • 발행 : 2010.03.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness in both lower extremities, and urinary incontinence, suggesting cauda equina syndrome. Magnetic resonance imaging suggested the sequestrated disc fragment located in the extradural space at the L4-L5 level had surrounded and compressed the dural sac from the lateral to dorsal sides. A bilateral decompressive laminectomy was performed under an operating microscope. A large extruded disc was found to have migrated from the ventral aspect, around the thecal sac, and into the dorsal aspect, which compressed the sac to the right. After removal of the disc fragment, his sciatica was relieved and the patient felt strength of lower extremity improved.

키워드

참고문헌

  1. Baker JK, Hanson GW : Cyst of the ligamentum flavum. Spine (Phila Pa 1976) 19 : 1092-1094, 1994 https://doi.org/10.1097/00007632-199405000-00019
  2. Bonaroti EA, Welch WC : Posterior epidural migration of an extruded lumbar disc fragment causing cauda equine syndrome. Clinical and magnetic resonance imaging evaluation. Spine (Phila Pa 1976) 23 : 378-381, 1998 https://doi.org/10.1097/00007632-199802010-00018
  3. Brock M, Patt S, Mayer HM : The form and structure of extruded disc. Spine (Phila Pa 1976) 17 : 1457-1461, 1992 https://doi.org/10.1097/00007632-199212000-00003
  4. Coscia M, Lepzig T, Cooper D : Acute cauda equina syndrome. Diagnostic advantage of MRI. Spine (Phila Pa 1976) 19 : 475-478, 1994 https://doi.org/10.1097/00007632-199402001-00020
  5. Hogan QH : Lumbar epidural anatomy. A new look by cryomicrotome section. Anaesthesiology 75 : 767-775, 1991 https://doi.org/10.1097/00000542-199111000-00007
  6. Kim JH, Kong MH, Lee SK, Song KY : A case of posterior epidural migration an extruded lumbar disc fragement causion cauda eqiuna syndrome. J Korean Neurosurg Soc 35 : 442-444, 2004
  7. Kim MS, Hur JW, Lee JW, Lee HK : Posterior and lateral epidural migration of extruded lumbar disc fragments : case report. J Korean Neurosurg Soc 33 : 297-298, 2003
  8. Kim SJ, Song JH, Kim MH, Park HK, Kim SH, Shin KM, et al. : Sequestrated disc mimicking benign neurogenic tumor : report of 2 cases. J Korean Neurosurg Soc 26 : 596-599, 1997
  9. Kuzeyli K, Cakir E, Usul H, Baykal S, Yazar U, Karaarslan G, et al. : Posterior epidural migration of lumbar disc fragments : report of three cases. Spine (Phila Pa 1976) 28 : E64-E67, 2003
  10. Lakshmanan P, Ahuja S, Lyons K, Howes J, Davies PR : Sequestrated lumbar intervertebral disc in the posterior epidural space : a report on two cases and review of the literature. Spine J 6 : 583-586, 2006 https://doi.org/10.1016/j.spinee.2005.09.009
  11. Lichtor T : Posterior epidural migration of extruded lumbar disc. Surg Neurol 32 : 311-312, 1989 https://doi.org/10.1016/0090-3019(89)90236-X
  12. Liu SS, Williams KD, Drayer BP, Spetzler RF, Sonntag VK : Synovial cysts of the lumbosacral spine : diagnosis by MR imaging. AJR Am J Roentgenol 154 : 163-166,1990 https://doi.org/10.2214/ajr.154.1.2104702
  13. Lombardi V : Lumbar spinal block by posterior rotation of anulus fibrosis. Case report. J Neurosurg 39 : 642-644,1973 https://doi.org/10.3171/jns.1973.39.5.0642
  14. Olmarker K, Blomquist J, Stromberg J, Nannmark U, Thomsen P, Rydevik B : Inflammatogenic properties of nucleus pulposus. Spine (Phila Pa 1976) 20 : 665-669, 1995 https://doi.org/10.1097/00007632-199503150-00006
  15. Robe P, Martin D, Lenelle J, Stevenaert A : Posterior epidural migration of sequestrated lumbar disc fragments : report of two cases. J Neurosurg 90 : 264-266, 1999
  16. Sandhu FS, Dillon WP : Spinal epidural abscess : evaluation with contrast-enhanced MR imaging. AJNR Am J Neuroradiol 12 : 1087-1093, 1991
  17. Schellinger D, Manz HJ, Vidic B, Patronas NJ, Deveikis JP, Muraki AS, et al. : Disc fragment migration. Radiology 175 : 831-836, 1990 https://doi.org/10.1148/radiology.175.3.2343133
  18. Sen O, Aydin MV, Erdogan B, Yildirim T, Caner H : Cauda equina syndrome caused by posterior epidural migration of an extruded lumbar disc fragment. Turk Neurosurg 11 : 108-110, 2001
  19. Williams AL, Haughton VM, Danials DL, Grogan JP : Differential CT Diagnosis of extruded nucleus pulposus. Radiology 148 : 141-148, 1983 https://doi.org/10.1148/radiology.148.1.6856824
  20. Wiltse LL, Fonseca AS, Amster J, Dimartino P, Ravessoud FA : Relationship of the dura, Hoffmann's ligaments, Batson's plexus and a fibrovascular membrane lying on the posterior surface of the vertebral bodies and attaching to the deep layer of the posterior longitudinal ligament. An anatomical, radiologic and clinical study. Spine (Phila Pa 1976) 18 : 1030-1043, 1993 https://doi.org/10.1097/00007632-199306150-00013

피인용 문헌

  1. Clinical and Radiographic Characteristics of Upper Lumbar Disc Herniation: Ten-Year Microsurgical Experience vol.51, pp.6, 2010, https://doi.org/10.2176/nmc.51.423
  2. Posterior epidural migration of a lumbar disc fragment: a series of 6 cases : A review vol.15, pp.1, 2011, https://doi.org/10.3171/2011.3.spine10832
  3. Posterior migration of lumbar disc herniation - imaging dilemma due to contrast contraindication: a case report vol.45, pp.3, 2010, https://doi.org/10.1590/s0100-39842012000300010
  4. Efficacy of Delayed Decompression of Lumbar Disk Herniation Causing Cauda Equina Syndrome vol.37, pp.2, 2010, https://doi.org/10.3928/01477447-20140124-18
  5. Migratory Intradural Disk Herniation and a Strategy for Intraoperative Localization vol.5, pp.1, 2015, https://doi.org/10.1055/s-0034-1381728
  6. Two Cases of Dorsal Epidural Migration of Lumbar Disk Fragments vol.25, pp.1, 2010, https://doi.org/10.1097/wnq.0000000000000008
  7. Letter to the Editor: Posterior epidural migration of lumbar intervertebral disc fragment vol.23, pp.1, 2015, https://doi.org/10.3171/2011.2.spine1190
  8. Posterior Epidural Migration of a Sequestrated Lumbar Disk Fragment Causing Cauda Equina Syndrome in an Old Patient: A Case Report vol.9, pp.None, 2010, https://doi.org/10.4137/ccrep.s39139
  9. Postdural disc herniation at L5/S1 level mimicking an extradural spinal tumor vol.25, pp.suppl1, 2016, https://doi.org/10.1007/s00586-015-4125-5
  10. Dorsal Lumbar Disc Migrations with Lateral and Ventral Epidural Extension on Axial MRI: A Case Series and Review of the Literature vol.37, pp.11, 2016, https://doi.org/10.3174/ajnr.a4875
  11. Anterior-to-Posterior Migration of a Lumbar Disc Sequestration: Surgical Remarks and Technical Notes about a Tailored Microsurgical Discectomy vol.2017, pp.None, 2017, https://doi.org/10.1155/2017/1762047
  12. Posterior Epidural Migration of a Lumbar Intervertebral Disc Fragment Resembling a Spinal Tumor: A Case Report vol.42, pp.4, 2010, https://doi.org/10.5535/arm.2018.42.4.621
  13. Posterior epidural migration of herniated lumbar disc fragment: a literature review vol.42, pp.4, 2010, https://doi.org/10.1007/s10143-018-01065-1
  14. Dorsal migration of lumbar disc fragments causing cauda equina syndromes: A three case series and literature review vol.11, pp.None, 2010, https://doi.org/10.25259/sni_197_2020
  15. Dorsal migration of prolapsed intervertebral disc causing cauda equina syndrome vol.13, pp.9, 2010, https://doi.org/10.1136/bcr-2020-238017
  16. Lumbar disc sequestration through the dura into the intrathecal space presenting as acute cauda equina vol.14, pp.5, 2010, https://doi.org/10.1136/bcr-2021-241983
  17. Posterior epidural sequestrated disc presenting with contralateral radiculopathy: a very rare case vol.7, pp.1, 2021, https://doi.org/10.1038/s41394-021-00460-z