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KMID : 1146020120050010015
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Journal of Critical Spine Cases
2012 Volume.5 No. 1 p.15 ~ p.17
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Recurrent Intradural Disc Herniation
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Hwang Chul-Yoon
Lee Chul-Jae
Hwang Byeong-Wook
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Abstract
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Intradural disc herniation is thought be a rare pathological entity. The preoperative knowledge of intradural disc herniation is important because it has an influence on the operative strategy. We report a case of recurrent intradural disc herniation which occurred after two lumbar discectomies. A male patient, 31 years of age, visited our hospital presenting a one-week history of severe radiating pain in his left leg and paralysis. He underwent two lumbar discectomies 4 and 12 years ago respectively. Magnetic resonance imaging revealed a disc herniation with a posterolateral extruded fragment on the left side and a mass-like lesion in the dural sac at the level of the L4-5 disc space. Revisional surgery was performed, and the posterolateral extradural extruded disc material was removed. Then a subsequent durotomy was performed, and intradural disc fragment was successfully removed. The patient experienced a marked reduction of pain and progressive recovery of sensory disturbance and motor weakness. He was discharged seven days after surgery, and subsequent recovery was uneventful. We must suspect the possibility of intradural disc herniation when preoperative radiologic findings and intraoperative findings are different. We must be aware of this rare pathology, which, if overlooked during the operation, could have unexpected consequences for the patient.
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KEYWORD
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Disc herniation, Intradural, Lumbar, Recurrent
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