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Migratory intradural disk herniation and a strategy for intraoperative localization.
Scott D Daffner1, Cara L Sedney2, Charles L Rosen2
1Department of Orthopaedics, West Virginia University School of Medicine, Morgantown, West Virginia, United States.
Global Spine Journal
|February 5, 2015
Summary
Intradural disk herniation is rare and challenging to diagnose. This case report details a migrated intradural disk and proposes intraoperative myelography for improved localization.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Diagnostic Imaging
Background:
- Intradural disk herniations (IDH) are uncommon spinal pathologies.
- Diagnosis can be challenging, often requiring surgical exploration.
- Migrated intradural disks present unique diagnostic difficulties.
Observation:
- A case of a migrated intradural disk is presented.
- Preoperative imaging did not reveal the herniated fragment.
- Intraoperative findings were incongruent with initial imaging.
Findings:
- The study provides the first intraoperative imaging evidence of disk migration.
- A novel strategy for locating intradural disk fragments before durotomy is proposed.
- Intraoperative myelography is suggested as a valuable localization tool.
Implications:
- Highlights the importance of considering IDH when intraoperative findings mismatch imaging.
- Suggests intraoperative myelography as a key technique for difficult IDH cases.
- Aids surgeons in improving diagnostic accuracy and surgical planning for IDH.
