Related Experiment Video
Updated: May 28, 2026
05:53
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
A patient with thoracic intradural disc herniation
Robert G Whitmore1, Brian J Williams, Bradley C Lega
1Department of Neurosurgery, Hospital of The University of Pennsylvania, 3400 Spruce Street, 3rd Floor Silverstein, Philadelphia, PA 19104, USA. robert.whitmore@uphs.upenn.edu
Summary
Thoracic intradural disc herniation is rare, often missed on MRI. Surgical removal led to good recovery in a T12-L1 case, highlighting the importance of intraoperative identification for this spinal condition.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Intradural disc herniation (IDH) is an uncommon spinal pathology, predominantly affecting the lumbar region.
- Thoracic and cervical IDH constitute less than 5% of all cases, presenting diagnostic challenges.
Observation:
- A patient presented with radiculopathy and motor weakness attributed to a T12-L1 disc herniation.
- Preoperative magnetic resonance imaging (MRI) failed to identify the intradural nature of the lesion.
- The intradural disc herniation was confirmed intraoperatively via direct visualization and palpation of the thecal sac.
Findings:
- Surgical excision of the intradural disc fragment was performed.
- The patient demonstrated significant neurological recovery following the procedure.
- The patient remained pain-free one year post-surgery, indicating successful treatment.
Implications:
- This case underscores the potential for preoperative imaging to miss thoracic intradural disc herniations.
- Intraoperative identification is crucial for managing this rare spinal condition.
- Prompt surgical intervention can lead to favorable long-term outcomes and pain relief.
Related Concept Videos
01:29Herniated Intervertebral Disc l: Introduction
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
01:27Degenerative Disc Disease I: Introduction
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
01:23Degenerative Disc Disease ll: Pathophysiology
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...