INTRARADICULAR LUMBAR DISC HERNIATION - CASE-REPORT AND REVIEW OF THELITERATURE

Citation
T. Suzer et al., INTRARADICULAR LUMBAR DISC HERNIATION - CASE-REPORT AND REVIEW OF THELITERATURE, Neurosurgery, 41(4), 1997, pp. 956-958
Citations number
21
Categorie Soggetti
Surgery,"Clinical Neurology
Journal title
ISSN journal
0148396X
Volume
41
Issue
4
Year of publication
1997
Pages
956 - 958
Database
ISI
SICI code
0148-396X(1997)41:4<956:ILDH-C>2.0.ZU;2-D
Abstract
OBJECTIVE AND IMPORTANCE: Intradural or intraradicular herniation of a lumbar disc is a rave complication of disc disease. The mechanism of the tearing of the dura mater by a herniated disc is not known with ce rtainty. Only six cases of intraradicular disc herniation have been re ported. By reporting the seventh case of this rare neurosurgical entit y, we emphasize its importance and review the literature on intraradic ular disc herniation. CLINICAL PRESENTATION: A 41-year-old man was adm itted with a 3-year history of low back pain and sciatica. A neurologi cal examination revealed motor weakness during plantar flexion, positi ve Lasegue's sign, sensory deficit on the S1 dermatoma, and loss of Ac hilles reflex. Magnetic resonance imaging revealed disc protrusion at the L5-S1 level. Therefore, we decided to operate on the patient havin g made a diagnosis of lumbar disc disease. INTERVENTION: The patient u nderwent a standard hemilaminotomy and foraminotomy for a removal of t he L5-S1 disc. There was no disc protrusion or extruded fragment. The left S1 nerve root was observed to be swollen and immobile. A longitud inal incision was made on the radicular sheet of the S1 root, and a fr ee disc fragment, approximately 2 x 1 x 1 cm, was extirpated in one pi ece, CONCLUSION: The patient was immediately relieved of pain and was discharged on the 7th day after the operation with normal muscle stren gth. It seems probable that in some patients with ''failed back syndro me,'' intraradicular or intradural disc herniation is the cause of fai lure.