Intradural Dorsolumbar Disc Herniation: Case Report and literature Review

Norbery De La Paz

doi:10.31579/2578-8868/171

Abstract

Intradural disc herniation is a rare entity, representing between 0.26% and 0.30% of all herniated discs. 92% of cases occur in the lumbar spine, more frequent at the L4-L5 level. The diagnostic and therapeutic conduct performed in a 61-year-old male patient who came to the office with a one-year and six-month history of dorsolumbar pain is described, accompanied by sensory alterations in the lower limbs. In view of the exacerbation of symptoms, a simple magnetic resonance study was performed, observing an intraspinal, intradural, extramedullary lesion at the D12-L1 space. An intradural disc herniation is suspected. After being evaluated the case in the group of Neurosurgeons (Group of Spinal Surgery) of the Institute of Neurology and Neurosurgery of Havana, it is proposed to carry out surgical treatment, which consisted of the extraction with microsurgical technique of the Herniated disc, preserving the vertebral anatomy through the laminoplasty technique, an open book variant. The patient evolved satisfactorily after three months of follow-up. It is concluded that intradural disc herniation should be included among intradural, extraxial lesions of the spine. By means of the magnetic resonance study, a group of imaging signs that support the preoperative diagnosis of this lesion can be described. Surgery is the definitive therapeutic method and allows an accurate diagnosis of spinal herniation to be established.

Highlights

Herniated discs represent a common manifestation of degenerative spinal disease
An intradural disc herniation is suspected.After being evaluated the case in the group of Neurosurgeons (Group of Spinal Surgery) of the Institute of Neurology and Neurosurgery of Havana, it is proposed to carry out surgical treatment, which consisted of the extraction with microsurgical technique of the Herniated disc, preserving the vertebral anatomy through the laminoplasty technique, an open book variant
By means of the magnetic resonance study, a group of imaging signs that support the preoperative diagnosis of this lesion can be described

Summary

Introduction

Herniated discs represent a common manifestation of degenerative spinal disease. They originate from a tension failure of the annulus fibrosus to contain the nuclear portion of the disc in gel form [1]. In 1942 Dandy published the first case of a patient with HDI, since only a low percentage of them have been reported in the medical literature This entity represents between 0.26% and 0.30% of all herniated discs, 3% occurs in the cervical region, 5% in the thoracic region, and 92% occurs in the lumbar spine, more frequent at the L4level. 61-year-old male patient with dorsolumbar pain of one year and six months of evolution, pain of mild to moderate intensity, with irradiation to the gluteal region, with transitory improvement after the administration of analgesics and antineuritics. Later it begins with a burning sensation, cramping and numbness in the posterior region of the thighs and legs. A regular outpatient follow-up was carried out, recovering fully 3 months after surgery

Discussion

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Conclusion