Rodrigo Víctor, Claramonte Marta, Martín Mónica, Calatayud Juan B
Department of Neurosurgery, Hospital Clínico Universitario Lozano Blesa, C/San Juan Bosco 15, 50009, Zaragoza, Spain.
Acta Neurochir (Wien). 2018 May;160(5):945-947. doi: 10.1007/s00701-018-3510-3. Epub 2018 Mar 12.
Intradural disc herniation is a rare phenomenon in spine surgery. Diagnosis is difficult despite current neuroradiologic imaging techniques.
We present a case of a 59-year-old man with lumbar and radicular pain and a recurrent lumbar herniation. A laminectomy was performed after no clear disc herniation in the epidural space was found and an intradural mass was palpable. A durotomy showed an intradural disc fragment that was removed, followed by an arthrodesis.
Only intraoperative findings lead to a definitive diagnosis for intradural herniation. A durotomy needs to be performed. In this case, an arthrodesis was necessary to avoid complications of segmental instability.
硬脊膜内椎间盘突出在脊柱外科中是一种罕见现象。尽管有当前的神经放射影像学技术，诊断仍很困难。
我们报告一例59岁男性患者，有腰痛和神经根性疼痛，且存在复发性腰椎间盘突出。在硬膜外间隙未发现明确的椎间盘突出且可触及硬脊膜内肿物后，实施了椎板切除术。硬脊膜切开显示有一个硬脊膜内椎间盘碎片，将其取出，随后进行了椎间融合术。
只有术中发现才能对硬脊膜内椎间盘突出做出明确诊断。需要进行硬脊膜切开术。在这种情况下，为避免节段性不稳定的并发症，进行椎间融合术是必要的。
