Intradural disc herniation: A case report and literature review

Abstract

Background: Intradural disc herniation (IDH) is rare and is thought to be caused by posterior longitudinal ligament and posterior adhesions. MRI findings are inadequate for definitive diagnosis. We reported a patient with an L4-5 IDH and reviewed the literature.

Case Description: A 71-year-old male patient presented with acute exacerbation of right lower extremity radiculopathy. MRI with/without contrast suggested IDH and spinal cord compression at the L4-5 spine level. While elective surgery was planned for the patient who did not have motor deficits at the time of admission, he underwent emergency surgery due to sudden urinary incontinence. At surgery, the disc herniation was appropriately resected, the dura was closed.

Conclusion: Although MRI is helpful in the diagnosis of IDH, the definitive diagnosis is made intraoperatively. In surgery, both the extradural and intradural disc components should be removed and as small laminectomy and dura incision as possible.