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Updated: Feb 16, 2026

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
Intradural lumbar disc herniation detected by 3D CISS MRI
Laurence Crivelli1, Vincent Dunet1
1Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
Abstract:
A 73-year-old man who presented with right lumbosciatic pain underwent a neurosurgical operation for a voluminous L2-L3 disc herniation, seen on conventional MRI images. No disc herniation was identified in the epidural space during the surgery. Just after the operation, the patient started to present pain in the left L3 territory and was not able to walk any more. A second MRI including three-dimensional (3D) high-resolution constructive interference in steady state (CISS) sequence showed that the voluminous L2-L3 disc split the posterior longitudinal ligament and the anterior dura mater, extended intradurally and compressed the cauda equina to the right. The patient underwent a second surgery, which permitted to cure the symptoms. 3D high-resolution CISS should be considered to accurately depict intradural disc herniation in order to optimally guide the surgical approach.
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