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KMID : 1099620170140030115
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Korean Journal of Spine
2017 Volume.14 No. 3 p.115 ~ p.117
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Posterior Epidural Herniation of a Lumbar Disk Fragment at L2?3 That Mimicked an Epidural Hematoma
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Kil Jin-Sang
Park Jong-Tae
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Abstract
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Lumbar disk herniation is common. Because of the posterior longitudinal ligament, migration usually occurs into the ventral epidural space. Rarely, fragments migrate into the dorsal epidural space. A 57-year-old man presented with lower back pain and weakness on right hip flexion and right knee flexion. He had lower back pain 1 day previously and received a transforaminal epidural block at a local hospital. The next day, he reported weakness of the right lower extremity. Lumbar spine magnetic resonance imaging revealed a dorsal epidural lesion with compression of the thecal sac at L2?3. Initial differential diagnoses included epidural hematoma after the block, neoplasm, and a sequestrated disk. Posterior lumbar decompression was performed. The lesion was identified intraoperatively as a large herniated disk fragment. Posterior epidural herniation of a lumbar disk fragment is rare and may be difficult to diagnose preoperatively. It may present as a variety of clinical scenarios and, as in this case, may mimic epidural hematoma.
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KEYWORD
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Intervertebral disc, Herniation, Epidural space, Epidural Hematoma
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