Multispecialty perspective on intradural disc herniation: diagnosis and management - A case report -
- Author:
Vinicius Tieppo FRANCIO
1
;
Christopher S. WIE
;
Micheal T. MURPHY
;
Matthew T. NEAL
;
Mark K. LYONS
;
Wende N. GIBBS
;
Natalie H. STRAND
Author Information
- Publication Type:Case Report
- From:Anesthesia and Pain Medicine 2022;17(2):221-227
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
