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Dorsal epidural intervertebral disk herniation with atypical radiographic findings: case report and literature review

Sonia G Teufack1, Harminder Singh, James Harrop

  • 1Department of Neurological Surgery, Thomas Jefferson University Hospital, 909 Walnut Street, 3rd floor, Philadelphia, PA 19107, USA. sonigary@gmail.com

The Journal of Spinal Cord Medicine
|August 27, 2010
PubMed
Abstract

Insights

Dorsal migration of herniated intervertebral discs is rare, often mimicking other spinal conditions. This case highlights the diagnostic challenges and surgical considerations for this unusual presentation.

Area of Science:

  • Neurosurgery
  • Spinal Imaging
  • Anatomy

Background:

  • Intervertebral disc herniation is common, typically migrating ventrally.
  • Dorsal migration is rare due to anatomical barriers like the thecal sac.

Observation:

  • A 49-year-old male presented with severe back pain, radiculopathy, and lower extremity weakness.
  • Lumbar MRI revealed a dorsal epidural lesion compressing the thecal sac.

Findings:

  • Preoperative diagnosis was challenging, with differentials including hematoma, cyst, or abscess.
  • Intraoperative findings confirmed a large herniated disc fragment in the dorsal epidural space.

Implications:

  • Dorsal disc herniation presents unique diagnostic difficulties.
  • It can mimic other dorsal epidural lesions on MRI.
  • Surgical intervention may be required for decompression.

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