Transdural herniated lumbar disc disease with muscle patch for closure of durotomy – A Brief review of literature

Huliyappa, Harsha A.; Singh, Rakesh Kumar; Singh, Sunil Kumar; Jaiswal, Manish; Jaiswal, Somil; Srivastava, Chhitij; Ojha, Bal Krishna; Chandra, Anil; Chhabra, Satnam Singh

doi:10.1016/j.pjnns.2016.12.002

Cited by 10 publications

(7 citation statements)

References 41 publications

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“…Thohar Arifin et al suggested a microsurgical approach with a median or paramedian dural incision to better observe the intradural disc and avoid damage to the nerve roots (31). Huliyappa et al found that after the removal of the intervertebral disc in the spinal canal, further resection of the intervertebral disc was not required, and intervertebral fusion might not be required (32). In our case, we perform the standard laminectomy followed by microscopically assisted incision of the dural sac to separate the nerve roots and remove the disc fragments.…”

Section: Treatmentmentioning

confidence: 99%

“…In 2018, Kim et al reported the first case of lumbar 2/3 ILDH via transforaminal endoscopic approach, and a good clinical effect was obtained after an 8-month follow-up (13). In 2017, Huliyappa et al reported a case of lumbar 5/sacral 1 segment ILDH treated with posterior percutaneous spinal endoscopy (32). In 2020, Moon et al reported a case in which the lumbar 2/3 intervertebral disc was removed under a laparoscope (33).…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Intradural disc herniation at the L2/3 level: a case report and literature review

Wen¹,

Xiao²,

Chen³

et al. 2022

Ann Palliat Med

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Background: Intradural lumbar disc herniation (ILDH) is special type of lumbar disc herniation in which the lumbar nucleus pulposus prolapses and enters the dura mater. ILDHs comprise 0.04-0.33% of all herniated discs. In most cases, the diagnosis could not be confirmed preoperatively by identifying the typical features of ILDH in radiological evaluation. In the current report, we present a case of ILDH at lumbar 2/3 level and discuss the clinical presentations, typical imaging features, treatments, and outcomes.Case Description: We describe a rare case of ILDH. The patient was a 65-year-old man with pain in waist and back, and with bilateral radiating pain of lower extremities and fatigue for more than 2 weeks.Magnetic resonance imaging (MRI) revealed a large round, low-density mass at lumbar 2/3, which was easily mimicked as an intradural spinal tumor lesion. While enhanced MRI showed the typical rim enhancement sign and "Hawk beak" sign. Due to progressive decrease in muscle strength in both lower limbs, posterior microscopically assisted laminectomy, dural incision of the lumbar 2/3 was performed. Pathological examination revealed degenerated fibrous connective tissue and cartilage tissue. The patient's lower back pain and radiating pain and numbness of both legs improved remarkably postoperatively, and he became asymptomatic at 3 months and 1-year postoperatively.Conclusions: ILDH is a rare intervertebral disc herniation in clinical practice. The pathogenesis of ILDH may be related to aseptic inflammatory edema, closely fixing of ventral dura and the posterior longitudinal ligament, repeated mechanical action and chemical corrosion. Typical rim enhancement sign, "Hawk beak" sign and "Y" sign are important features of MRI in diagnosing ILDH, and intraspinal gas is also helpful in computed tomography (CT) diagnosis of ILDH. Prompt microscopically assisted laminectomy, dura mater incision to remove the intradural disc, pedicle screw fixation regardless of fusion, surgical results are usually favorable. We also reviewed the literature and discussed the epidemiology, potential pathogenesis, diagnosis, treatment and poor prognostic factors of ILDH.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Intradural disc herniation at the L2/3 level: a case report and literature review

Wen¹,

Xiao²,

Chen³

et al. 2022

Ann Palliat Med

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“…Lumbar IDH is a rare classification of disc herniation [ 11 , 12 ]. In addition, IDH is difficult to diagnose preoperatively based on clinical symptoms or radiologic studies.…”

Section: Discussionmentioning

confidence: 99%

Intradural lumbar disc herniation: A case report and literature review

Cheng¹,

MD²,

Lin³

et al. 2022

Heliyon

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“…The pathogenesis of IDH remains unclear, however few theories have been proposed. Several reports suggested that certain factors like reduced epidural space resulting from congenital or iatrogenic narrowing of spinal canal, adhesions between annulus fibrosus, posterior longitudinal ligament (PLL) and ventral dura matter were responsible for IDH [7], [8]. Among the aformentiond pathogenesis adhesion between PLL and ventral dura matter was considered to be an important factor [9], [10].…”

Section: Discussionmentioning

confidence: 99%

A case of intradural lumbar disc herniation

Bhattarai

Gurung

Shrestha

et al. 2021

Preprint

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Transdural herniated lumbar disc disease with muscle patch for closure of durotomy – A Brief review of literature

Abstract: Autologous muscle patch with fibrin glue for dural rent closure is a simple and effective method which can be performed by endoscopic or minimally invasive approaches. Suturing the dura, being a tedious and cumbersome procedure can be avoided.

Cited by 10 publications

References 41 publications

Intradural disc herniation at the L2/3 level: a case report and literature review

Intradural disc herniation at the L2/3 level: a case report and literature review

Intradural lumbar disc herniation: A case report and literature review

A case of intradural lumbar disc herniation

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