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KMID : 0378019750180050711
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New Medical Journal
1975 Volume.18 No. 5 p.711 ~ p.714
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A Case of Intradural Herniated Lumbar Disc
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Abstract
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The intradural herniated lumbar disc is apparently rare disease. It is in general that the herniated lumbar disc is situated intrathecally through the perforation of the posterolateral aspect of the ventral surface of the spinal dura. Since the first report of Dandy in 1942, only 13 such cases have been reported. In Korea, 2 cases reported in 1972 and 1974.
The patient of the intradural herniated lumbar disc have usually a long history of recurrent low back pain and radiating on the both lower extremities.
A 61 year old female was admitted to Busan National University Hospital, who was complained of severe low back pain and radiating pain on the both lower extremities of about 30 years duration. Such pains were more aggrevated by forward bending and left lateralward flexion of the lumbar region.
She had been hypochondriacal neurosis. Neurological examination showed tenderness on the L4, and L5 spinous areas, hypoesthesia on the L4 and L5 dermatomes, no saddle anesthesia, and slight motor weakness of the dorsiflexion of the left extremity.
Myelogram showed complete block at the L4-5 interspace on lateral projection.
Total laminectomy of the L4 and L5 laminae were done. When the dura was opened, 1.5X0.5X0.5 cm sized disc mass was seen between the left posterolateral aspect of the ventral surface of the spinal dura and arachnoid in the L4-5 intervertebral space.
The protruded mass was removed after incision of the overlying arachnoid membrane and remaining L4-5 interspace disc materal was removed in pieces extradurally. The mass was revealed as a degenerated nucleus pulposus on microscopic examination.
The postoperative course was slightly improved but not apparently improved due to hypochondrial neurosis and longstanding history.
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