Intradural Dorsolumbar Disc Herniation: Case Report and literature Review

Abstract

Intradural disc herniation is a rare entity, representing between 0.26% and 0.30% of all herniated discs. 92% of cases occur in the lumbar spine, more frequent at the L4-L5 level. The diagnostic and therapeutic conduct performed in a 61-year-old male patient who came to the office with a one-year and six-month history of dorsolumbar pain is described, accompanied by sensory alterations in the lower limbs. In view of the exacerbation of symptoms, a simple magnetic resonance study was performed, observing an intraspinal, intradural, extramedullary lesion at the D12-L1 space. An intradural disc herniation is suspected. After being evaluated the case in the group of Neurosurgeons (Group of Spinal Surgery) of the Institute of Neurology and Neurosurgery of Havana, it is proposed to carry out surgical treatment, which consisted of the extraction with microsurgical technique of the Herniated disc, preserving the vertebral anatomy through the laminoplasty technique, an open book variant. The patient evolved satisfactorily after three months of follow-up. It is concluded that intradural disc herniation should be included among intradural, extraxial lesions of the spine. By means of the magnetic resonance study, a group of imaging signs that support the preoperative diagnosis of this lesion can be described. Surgery is the definitive therapeutic method and allows an accurate diagnosis of spinal herniation to be established.