Ashraf Almas, Babar Zaheer-Ud-Din
Neurosurgery, Shifa College of Medicine, Islamabad, PAK.
Neurosurgery, Shifa International Hospital, Islamabad, PAK.
Cureus. 2020 Apr 9;12(4):e7600. doi: 10.7759/cureus.7600.
Intradural disc herniation is a rare complication that is difficult to diagnose preoperatively, despite the availability of various radiological imaging tools. We report a case of a 61-year-old man with L4-L5 lumbar disc herniation who presented with back pain radiating to both legs, difficulty in walking, and urinary incontinence. Magnetic resonance imaging showed a disc bulge at the L4-L5 level. However, fragment was not seen until perioperatively; a disc fragment was found in the intradural space. While various radiological techniques have been reported in the literature for diagnosing herniated discs, an absolute diagnosis of intradural disc herniation by a single radiological investigation is unreliable. The current case demonstrates the limitations of various diagnostic methods available. We also present a review of the literature regarding possible modalities to aid diagnosis.
硬膜内椎间盘突出是一种罕见的并发症，尽管有各种放射影像学工具，但术前很难诊断。我们报告一例61岁男性，患有L4-L5腰椎间盘突出症，表现为背部疼痛放射至双腿、行走困难和尿失禁。磁共振成像显示L4-L5水平有椎间盘膨出。然而，直到围手术期才发现碎片；在硬膜内间隙发现了一个椎间盘碎片。虽然文献中已经报道了各种用于诊断椎间盘突出的放射学技术，但通过单一放射学检查对硬膜内椎间盘突出进行绝对诊断是不可靠的。目前的病例证明了现有各种诊断方法的局限性。我们还对有关可能有助于诊断的方式的文献进行了综述。
