Lumbar Intradural Disc Herniation Manifesting as Cauda Equina Syndrome – Case Report

Česká verzia

Authors: J. Mraček
Authors place of work: Neurochirurgické oddělení FN Plzeň
Published in the journal: Cesk Slov Neurol N 2008; 71/104(5): 594-598
Category: Case Report

Summary

Lumbar disc herniation is a very frequent diagnosis. In exceptional cases a herniated sequestrum may penetrate the dura mater intrathecally. The clinical effects do not differ significantly from standard extradural herniation. Post‑contrast magnetic resonance imaging should function as a reliable diagnostic method at present. In spite of this, the intradural location of the sequestrum is very often only determined during surgery. Differential diagnosis should be considered for intradurally growing tumours. Microsurgical techniques must be used to remove the sequestrum and free the nerve tissue. The main cause of penetration of intradural space in herniation is thought to be adhesion between the dura mater and the posterior longitudinal ligament. The authors present a case of intradural herniation of lumbar disc L2/3, which led to cauda equina syndrome as a clinical consequence.

Key words:
intradural disc herniation – lumbar disc herniation – cauda equina syndrome – magnetic resonance imaging – microsurgery

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