Mraja Hamisi M, Kaya Ozcan, Mammadov Tural, Karadereler Selhan, Hamzaoglu Azmi
Istanbul Spine Center, Istanbul Florence Nightingale Hospital, Istanbul, TUR.
Orthopaedics and Traumatology, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR.
Cureus. 2022 Aug 1;14(8):e27568. doi: 10.7759/cureus.27568. eCollection 2022 Aug.
Protruded disc fragments that penetrate the posterior longitudinal ligament (PLL) migrate rostral or caudal in the vertical plane, some laterally in the horizontal plane, or into the foramina involving the anterior aspect of the spinal canal. Often, there is migration to the ventral epidural space. However, posterior epidural migration of a lumbar disc herniation (PEMLDH) is a rare phenomenon that makes the differential diagnosis challenging. We describe a rare case of anterior-to-posterior epidural migration of a lumbar disc herniation at the L1-L2 level. It was treated microsurgically after total laminectomy, and total resection of the lesion was carried out. PEMLDH is a unique condition causing neurological deficits at different levels. Due to different localization of disc herniations, optimal diagnosis becomes critical for determining the timing and type of treatment surgically.
突出的椎间盘碎片穿透后纵韧带（PLL）后，会在垂直平面内向上或向下移动，有些会在水平平面内向外侧移动，或进入椎间孔累及椎管前部。通常，会向腹侧硬膜外间隙移动。然而，腰椎间盘突出症的硬膜外后移（PEMLDH）是一种罕见现象，这使得鉴别诊断具有挑战性。我们描述了一例罕见的L1-L2水平腰椎间盘突出症硬膜外由前向后移位的病例。在全椎板切除术后进行了显微手术治疗，并对病变进行了完全切除。PEMLDH是一种独特的病症，会在不同水平导致神经功能缺损。由于椎间盘突出的位置不同，最佳诊断对于确定手术治疗的时机和类型至关重要。
