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Radicular interdural lumbar disc herniation.
Eur Spine J. 2010 Jul; 19 Suppl 2:S149-52.ES

Abstract

Intraradicular lumbar disc herniation is a rare complication of disc disease that is generally diagnosed only during surgery. The mechanism for herniated disc penetration into the intradural space is not known with certainty, but adhesion between the radicular dura and the posterior longitudinal ligament was suggested as the most important condition. The authors report the first case of an intraradicular lumbar disc herniation without subdural penetration; the disc hernia was lodged between the two radicular dura layers. The patient, a 34-year-old soldier, was admitted with a 12-month history of low back pain and episodic left sciatica. Neurologic examination showed a positive straight leg raising test on the left side without sensory, motor or sphincter disturbances. Spinal CT scan and MRI exploration revealed a left posterolateral osteophyte formation at the L5-S1 level with an irregular large disc herniation, which migrated superiorly. An intradural extension was suspected. A left L5 hemilaminectomy and S1 foraminotomy were performed. The exploration revealed a large fragment of disc material located between the inner and outer layers of the left S1 radicular dura. The mass was extirpated without cerebrospinal fluid outflow. The postoperative course was uneventful. Radicular interdural lumbar disc herniation should be suspected when a swollen, hard and immobile nerve root is present intraoperatively.

Authors+Show Affiliations

Department of Neurosurgery, Mohammed V Military Teaching Hospital, University of King Mohammed V-Souissi, Rabat, Morocco. akhaddar@hotmail.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19888608

Citation

Akhaddar, Ali, et al. "Radicular Interdural Lumbar Disc Herniation." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 19 Suppl 2, 2010, pp. S149-52.
Akhaddar A, Boulahroud O, Elasri A, et al. Radicular interdural lumbar disc herniation. Eur Spine J. 2010;19 Suppl 2:S149-52.
Akhaddar, A., Boulahroud, O., Elasri, A., Elmostarchid, B., & Boucetta, M. (2010). Radicular interdural lumbar disc herniation. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 19 Suppl 2, S149-52. https://doi.org/10.1007/s00586-009-1200-9
Akhaddar A, et al. Radicular Interdural Lumbar Disc Herniation. Eur Spine J. 2010;19 Suppl 2:S149-52. PubMed PMID: 19888608.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radicular interdural lumbar disc herniation. AU - Akhaddar,Ali, AU - Boulahroud,Omar, AU - Elasri,Abad, AU - Elmostarchid,Brahim, AU - Boucetta,Mohammed, Y1 - 2009/11/04/ PY - 2009/04/28/received PY - 2009/10/18/accepted PY - 2009/09/25/revised PY - 2009/11/6/entrez PY - 2009/11/6/pubmed PY - 2011/2/17/medline SP - S149 EP - 52 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 19 Suppl 2 N2 - Intraradicular lumbar disc herniation is a rare complication of disc disease that is generally diagnosed only during surgery. The mechanism for herniated disc penetration into the intradural space is not known with certainty, but adhesion between the radicular dura and the posterior longitudinal ligament was suggested as the most important condition. The authors report the first case of an intraradicular lumbar disc herniation without subdural penetration; the disc hernia was lodged between the two radicular dura layers. The patient, a 34-year-old soldier, was admitted with a 12-month history of low back pain and episodic left sciatica. Neurologic examination showed a positive straight leg raising test on the left side without sensory, motor or sphincter disturbances. Spinal CT scan and MRI exploration revealed a left posterolateral osteophyte formation at the L5-S1 level with an irregular large disc herniation, which migrated superiorly. An intradural extension was suspected. A left L5 hemilaminectomy and S1 foraminotomy were performed. The exploration revealed a large fragment of disc material located between the inner and outer layers of the left S1 radicular dura. The mass was extirpated without cerebrospinal fluid outflow. The postoperative course was uneventful. Radicular interdural lumbar disc herniation should be suspected when a swollen, hard and immobile nerve root is present intraoperatively. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/19888608/Radicular_interdural_lumbar_disc_herniation_ L2 - https://doi.org/10.1007/s00586-009-1200-9 DB - PRIME DP - Unbound Medicine ER -