Related Experiment Video
Updated: Jan 5, 2026
10:09
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
4.4K
Preoperative radiographic clues for transdural disc herniation: could it be predictable?
Moo Sung Kang1,2, Jeong Yoon Park1, Sung Uk Kuh1
1Department of Neurosurgery, Gangnam Severance Hospital, Spine and Spinal Cord Institute, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul, 06273, South Korea.
Acta Neurochirurgica
|October 27, 2019
Summary
Transdural disc herniation (TDH) is rare, but preoperative imaging can help identify it. More than two specific imaging findings suggest TDH, aiding surgical planning and preventing complications.
Area of Science:
- Neurosurgery
- Radiology
- Spinal Surgery
Background:
- Transdural disc herniation (TDH) is an uncommon condition, occurring in 0.3-1.5% of disc herniation cases.
- Recognizing TDH preoperatively is crucial to mitigate risks like cerebrospinal fluid leakage.
- This study aimed to analyze imaging findings and develop a predictive model for TDH.
Purpose of the Study:
- To identify key radiographic signs indicative of transdural disc herniation (TDH).
- To develop a preoperative prediction model for TDH based on imaging findings.
- To improve diagnostic accuracy and surgical safety for TDH cases.
Main Methods:
- Retrospective analysis of radiographic images from 7 TDH patients and 131 epidural disc herniation (EDH) control patients.
- Evaluation of eight specific radiographic signs, including dural tent absence, hawk-beak sign, and rim enhancement.
- Statistical comparison of radiographic findings between TDH and EDH groups to determine predictive value.
Main Results:
- The incidence of TDH was 1.33% in thoracic and 0.09% in lumbar cases.
- Statistically significant indicators for TDH included absence of dural tent (OR=106.67), double-layered lesion (OR=22.69), and increased dura-cauda equina distance (OR=52.00).
- A cutoff value of 1.5 based on summed findings demonstrated 85.7% sensitivity and 90.8% specificity.
Conclusions:
- Preoperative imaging plays a vital role in diagnosing transdural disc herniation (TDH).
- The presence of more than two specific imaging findings strongly suggests TDH, guiding surgical decisions.
- This predictive model enhances preoperative assessment and patient safety in suspected TDH cases.
