Multispecialty perspective on intradural disc herniation: diagnosis and management - A case report

Document Type

Article

Abstract

BACKGROUND: Intradural disc herniation (IDH) is a very rare and challenging diagnosis, with an estimated incidence of less than 1.5%. The pathogenesis of IDH remains uncertain. Definitive management remains surgical; however, some cases may initially be managed non-surgically. CASE: A middle-aged male with presented with acute right-sided lumbar radiculopathy following heavy lifting. History was significant for prior lumbar disc herniation managed non-surgically. Lumbar MRI demonstrated a large disc herniation. The patient was initially treated non-surgically with epidural steroid injections. At 4-months, he re-injured and follow-up images demonstrated the herniated disc penetrating the dura and the diagnosis of intradural disc herniation. CONCLUSIONS: The present case is rare because the IDH occurred at the L3-4 level and resulted in unilateral radiculopathy without cauda-equina symptoms and occurred in the absence of prior surgery. This patient was initially treated non-surgically with satisfactory relief, however, reinjury led to progression of IDH with new neurological deficits necessitating surgery.

Publication Date

4-1-2022

Publication Title

Anesthesia and pain medicine

E-ISSN

2383-7977

Volume

17

Issue

2

First Page

221

Last Page

227

PubMed ID

35378571

Digital Object Identifier (DOI)

10.17085/apm.21100

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