Epidural posterior migration of a disc fragment

Abstract

IntroductionThe posterior epidural migration of a fragment of lumbar disc herniation is a rare clinical presentation. Case reportWe report the case of a 76-year-old male patient with back pain and progressive paraparesis in the lower limbs, with the emergence of a cauda equina syndrome 4days after admission. MRI showed lumbar spondylosis and a well-defined intra-spinal mass in the posterior epidural space. Surgical resection of the epidural mass was performed. The pathological study revealed an intervertebral disc fragment; thus, it was a complete migration of a herniated lumbar disc. The patient was healed after surgery and specific rehabilitation treatment. ConclusionsPatients with posterior migration of disc fragment may present with severe neurological deficits, such as cauda equina syndrome. Because the radiological images of disc fragments are similar to those of other lesions, such as metastasis, synovial cyst, dural abscess or haematoma, definitive diagnosis is made by excision and pathological study. Emergency surgery is required to prevent severe neurological deficits.