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Posterior extradural lumbar disk fragment.

S D Hodges1, S C Humphreys, J C Eck

  • 1Center for Sports Medicine and Orthopaedics, Foundation for Research, Chattanooga, Tenn 37404, USA.

Journal of the Southern Orthopaedic Association
|July 23, 2002
PubMed
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A rare case of spinal stenosis caused by a sequestered disc fragment behind the thecal sac is presented. This finding highlights the importance of considering herniated discs in acute spinal stenosis, even without imaging evidence.

Area of Science:

  • Neurosurgery
  • Spinal Imaging
  • Neurology

Background:

  • Sequestered disc fragments typically migrate cranially or caudally.
  • Posterior displacement of disc fragments is uncommon.

Observation:

  • A patient presented with sudden onset bilateral groin and anterior thigh pain.
  • Magnetic resonance imaging revealed severe L4-L5 spinal stenosis with mild disc bulging.
  • Intraoperative findings included a large, encapsulated mass posterior to the thecal sac.

Findings:

  • A sequestered disc fragment was located posterior to the thecal sac, causing spinal stenosis and neurogenic claudication.
  • The fragment compressed the posterior aspect of the thecal sac.

Implications:

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  • Herniated discs should be considered in the differential diagnosis of acute spinal stenosis.
  • This case underscores the need for thorough evaluation, even when imaging is not definitive.
  • Highlights a rare cause of spinal stenosis requiring surgical consideration.