Sequestrated Intradural Disc Herniation Around Couns Medullaris - A Case Report -

Jaewon Lee; Wan-Sik Seo; Ye-Soo Park; Young-Ha Oh

doi:10.4184/jkss.2014.21.3.134

Journal List > J Korean Soc Spine Surg > v.21(3) > 1076027

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Lee, Seo, Park, and Oh: Sequestrated Intradural Disc Herniation Around Couns Medullaris - A Case Report -

Case Report

Journal of Korean Spine Surg 2014;21(3):134-138.

Published online: 21 September 2014

DOI: https://doi.org/10.4184/jkss.2014.21.3.134

Sequestrated Intradural Disc Herniation Around Couns Medullaris - A Case Report -

Jaewon Lee, M.D., Wan-Sik Seo, M.D., Ye-Soo Park, M.D., Young-Ha Oh, M.D.^∗

Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine

^∗Department of Pathology, Guri Hospital, Hanyang University College of Medicine

Corresponding author: Ye-Soo Park, M.D. Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, 153, Gyungchun-ro(St), Guri city, Gyunggi-do, 471-701, Korea TEL: +82-31-560-2317, FAX: +82-31-557-8781 E-mail: hyparkys@hanyang.ac.kr

Received 8 January 2014 Revised 13 March 2014 Accepted 12 June 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A case report.

Objectives

To report a rare case of intradural disc herniation (IDH) around conus medullaris.

Summary of Literature Review

IDH is rare with an incidence of less than 1% of all lumbar disc herniations. It is important to differentiate IDH from other condition with accurate diagnosis and subsequent surgical treatment. IDH has a higher risk of neurologic deficit, like conus medullaris syndrome and cauda equina syndrome.

Materials and Methods

A 62 year-old male was affected by lumbar back pain radiating to the anterolateral aspect of the right thigh for 5 days. MRI showed a mass that existed on the anterior portion of the conus medullaris. We performed partial laminectomy at the L1-L2level. The mass located anteriorly in the intradural space was eliminated after durotomy by a posterior approach.

Results

We confirmed the IDH for histopathology.

Conclusions

IDH usually needs accurate differential diagnosis. Preoperative MRI scans are necessary to differentiate IDH from other intradural lesions. The confirmative diagnosis can be done only in the operative field.

Keywords: Intradural disc herniation, Conus medullaris

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Fig. 1.

Preoperative AP (A) and lateral (B) x-rays. Intervertebral disc space of L1-2 is narrower than other intervertebral disc spaces.

Fig. 2.

T1- and T2-weighted images in non-contrast sagittal and axial MRI (T1WI) (A, B). Gadolinium-enhanced T1-weighted MRI shows ring enhancement of the mass(C).

Fig. 3.

Intraoperative clinical photo shows intradural egg-shaped mass after dural incision(A, B).

Fig. 4.

H-E stained histologic findings show degenerative disc. (A) original magnification x 40, (B) original magnification x 200.

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