Posterior Epidural Herniation of a Lumbar Disk Fragment at L2–3 That Mimicked an Epidural Hematoma.
10.14245/kjs.2017.14.3.115
- Author:
Jin Sang KIL
1
;
Jong Tae PARK
Author Information
1. Department of Neurosurgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine & Hospital, Iksan, Korea. jtpark@wku.ac.kr
- Publication Type:Case Report
- Keywords:
Intervertebral disc;
Herniation;
Epidural space;
Epidural Hematoma
- MeSH:
Decompression;
Diagnosis, Differential;
Epidural Space;
Hematoma*;
Hip;
Humans;
Intervertebral Disc;
Intervertebral Disc Displacement;
Knee;
Longitudinal Ligaments;
Low Back Pain;
Lower Extremity;
Magnetic Resonance Imaging;
Middle Aged;
Spine
- From:Korean Journal of Spine
2017;14(3):115-117
- CountryRepublic of Korea
- Language:English
-
Abstract:
Lumbar disk herniation is common. Because of the posterior longitudinal ligament, migration usually occurs into the ventral epidural space. Rarely, fragments migrate into the dorsal epidural space. A 57-year-old man presented with lower back pain and weakness on right hip flexion and right knee flexion. He had lower back pain 1 day previously and received a transforaminal epidural block at a local hospital. The next day, he reported weakness of the right lower extremity. Lumbar spine magnetic resonance imaging revealed a dorsal epidural lesion with compression of the thecal sac at L2–3. Initial differential diagnoses included epidural hematoma after the block, neoplasm, and a sequestrated disk. Posterior lumbar decompression was performed. The lesion was identified intraoperatively as a large herniated disk fragment. Posterior epidural herniation of a lumbar disk fragment is rare and may be difficult to diagnose preoperatively. It may present as a variety of clinical scenarios and, as in this case, may mimic epidural hematoma.
