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Posterior Epidural Migrated Lumbar Disc Fragment at L2-3 Level Mimicking an Extradural Spinal Tumor: A Case Report
Takuhei Kozaki1, Keiji Nagata1, Ryo Miyake1
1Department of Orthopaedic Surgery Wakayama Medical University, 811-1 Kimiidera, Wakayama, Japan.
Introduction:
Disc sequestration is well known as a perforation of the fibrous ring and posterior longitudinal ligament, and migration of the fragment to the epidural space.
Case Report:
A 62-year-old man complained of increased pain and hypoesthesia and muscle weakness of the left lower limb that had started 1 month before. Magnetic resonance imaging revealed a tumor-like mass at the L2-3 level on the posterior side of the dura. The fragment was strongly adhered to the dural sac and was resected piece by piece. Disc herniation recognized at L2-3 compressed the left L3 nerve root and was removed. The histopathological diagnosis was consistent with a degenerated intervertebral disc. All symptoms improved after the surgery.
Conclusion:
There are few reports about the posterior migrated disc herniation at higher lumbar level. It may be associated with fused segments from L4 to the pelvis due to the previous surgery, which impacted the adjacent segment.
