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http://dx.doi.org/10.3340/jkns.2012.52.2.156

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor  

Kim, Hyeong-Suk (Department of Neurosurgery, Research Institute of Clinical Medicine, Institute for Medical Science, Chonbuk National University Medical School and Hospital)
Eun, Jong-Pil (Department of Neurosurgery, Research Institute of Clinical Medicine, Institute for Medical Science, Chonbuk National University Medical School and Hospital)
Park, Jung-Soo (Department of Neurosurgery, Research Institute of Clinical Medicine, Institute for Medical Science, Chonbuk National University Medical School and Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.52, no.2, 2012 , pp. 156-158 More about this Journal
Abstract
Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.
Keywords
Intradural disc herniation; Spinal intradural tumor; Magnetic resonance imaging;
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Times Cited By Web Of Science : 0  (Related Records In Web of Science)
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1 Hidalgo-Ovejero AM, García-Mata S, Gozzi-Vallejo S, Izco-Cabezón T, Martínez-Morentín J, Martínez-Grande M : Intradural disc herniation and epidural gas : something more than a casual association? Spine (Phila Pa 1976) 29 : E463-E467, 2004   DOI   ScienceOn
2 Kataoka O, Nishibayashi Y, Sho T : Intradural lumbar disc herniation. Report of three cases with a review of the literature. Spine (Phila Pa 1976) 14 : 529-533, 1989   DOI   ScienceOn
3 KoKoc RK, Akdemir H, Oktem IS, Menku A : Intradural lumbar disc herniation : report of two cases. Neurosurg Rev 24 : 44-47, 2001   DOI   ScienceOn
4 Lyons AE, Wise BL : Subarachnoid rupture of intervertebral disc fragments. J Neurosurg 18 : 242-244, 1961   DOI
5 McCormick PC, Stein BM : Functional anatomy of the spinal cord and related structures. Neurosurg Clin N Am 1 : 469-489, 1990
6 Mut M, Berker M, Palaoglu S : Intraradicular disc herniations in the lumbar spine and a new classification of intradural disc herniations. Spinal Cord 39 : 545-548, 2001   DOI   ScienceOn
7 Ozdemir N, Yilmaz HS, Acar UD, Tektas S : Intraradicular lumbar disc herniation : report of two cases and review of the literature. Br J Neurosurg 18 : 637-643, 2004   DOI   ScienceOn
8 Ozturk A, Avci E, Yazgan P, Torun F, YucetaS S, Karabag H : Intradural herniation of intervertebral disc at the level of Lumbar 1-Lumbar 2. Turk Neurosurg 17 : 134-137, 2007
9 Sarliève P, Delabrousse E, Clair C, Hussein HH, Schmitt C, Kastler B : Intradural disc herniation with cranial migration of an excluded fragment. Clin Imaging 28 : 170-172, 2004   DOI   ScienceOn
10 Schisano G, Franco A, Nina P : Intraradicular and intradural lumbar disc herniation : experiences with nine cases. Surg Neurol 44 : 536-543, 1995   DOI   ScienceOn
11 Schisano G, Nina P : Intraradicular lumbar disc herniation : case report and review of the literature. Neurosurgery 43 : 400, 1998
12 Wasserstrom R, Mamourian AC, Black JF, Lehman RA : Intradural lumbar disk fragment with ring enhancement on MR. AJNR Am J Neuroradiol 14 : 401-404, 1993
13 Aydin MV, Ozel S, Sen O, Erdogan B, Yildirim T : Intradural disc mimicking : a spinal tumor lesion. Spinal Cord 42 : 52-54, 2004   DOI   ScienceOn
14 Benyamin R, Vallejo R, Yousuf N, Tamrazi A, Kramer J : Incidental diagnosis of intradural lumbar disc herniation during discography : a case report. Pain Pract 7 : 332-336, 2007   DOI   ScienceOn
15 Blikra G : Intradural herniated lumbar disc. J Neurosurg 31 : 676-679, 1969   DOI
16 Choi JY, Lee WS, Sung KH : Intradural lumbar disc herniation--is it predictable preoperatively? A report of two cases. Spine J 7 : 111-117, 2007   DOI   ScienceOn
17 Dandy WE : Serious complications of ruptured intervertebral disks. JAMA 119 : 474-477, 1942   DOI
18 Fardon DF, Milette PC : Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine (Phila Pa 1976) 26 : E93-E113, 2001   DOI   ScienceOn
19 Floeth F, Herdmann J : Chronic dura erosion and intradural lumbar disc herniation : CT and MR imaging and intraoperative photographs of a transdural sequestrectomy. Eur Spine J 21 Suppl 4 : S453-S457, 2012   DOI
20 Görgülü A, Karaaslan T, Tural O : Intradural and intraradicular lumbar disc herniations : case report and review of the literature. Norol Bil D 21 : 4, 2004
21 Han IH, Kim KS, Jin BH : Intradural lumbar disc herniations associated with epidural adhesion : report of two cases. J Korean Neurosurg Soc 46 : 168-171, 2009   DOI