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Upper Lumbar Intradural Disc Herniation: A Rare Case Report and Etiologic Analysis.
Jia Chen1,2, Hai-Jian Ni1,2, Fei Xue3
1Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, People's Republic of China.
Journal of Pain Research
|June 3, 2021
Summary
Intradural disc herniation (IDH) in the upper lumbar spine is rare and challenging to diagnose. Surgical removal of herniated disc fragments from within the dura improved patient symptoms.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Intradural disc herniation (IDH) is a rare spinal condition affecting the upper lumbar region.
- Diagnosis and surgical management of upper lumbar IDH present significant challenges.
Observation:
- A 63-year-old female presented with progressive leg pain due to an acute lumbar sprain.
- MRI revealed a herniated disc with a hawk-beak sign, indicating protrusion into the ventral dural sac.
Findings:
- Surgical exploration identified free disc fragments within the dura mater.
- Complete removal of the herniated nucleus pulposus tissue resulted in significant pain relief and improved mobility.
Implications:
- Enhanced MRI is crucial for diagnosing upper lumbar IDH.
- Surgical intervention and pathological examination are essential for definitive diagnosis and treatment of this rare condition.

