PEMLIF-a tale of two stories

Area of Science:

• Neurosurgery
• Orthopedics
• Spinal Cord Medicine

Background:

• Intervertebral disc prolapse commonly causes low back pain and neurological deficits due to ventral spinal cord compression.
• Dorsal migration of sequestrated disc fragments causing spinal cord compression is exceptionally rare.

Observation:

• Two patients presented with severe neurological deficits and back pain due to dorsally migrated lumbar disc fragments.
• One patient had a history of chronic back pain, while the other had no prior symptoms.
• Both cases involved dorsal migration of disc fragments compressing the spinal cord in the epidural space.

Findings:

• Surgical laminectomy and fragment removal provided only partial improvement in motor and bladder weakness.
• Diagnostic challenges were encountered in identifying the dorsal migration of the disc fragment.

Implications:

• This case series highlights the rarity and diagnostic difficulties of dorsal lumbar epidural disc migration.
• Understanding this rare pathology is crucial for accurate diagnosis and effective management of severe neurological deficits.
• Further research into optimal treatment strategies for dorsal disc fragment migration is warranted.