Posterior epidural migration of lumbar intervertebral fragment: case report

Abstract

Disc fragments are well known to migrate to superior, inferior, or lateral sites in the anterior epidural space, posterior epidural migrated lumbar disc fragments is an extremely rare disorder. Posterior epidural migrated lumbar disc fragments are often confused with other posterior epidural space-occupying lesions (cysts, abscesses, tumors, and hematomas). We reported the case of a 52- year-old man presented with progressive not systematizes bilateral radiculopathy complicated one week before admission a difficulty dorsiflexion prevents the start, and the stared to use crutches. Clinical examination revealed steppage gait and a strength score of 3/5 on dorsiflexion of feet. MR imaging of lumbar spine showed right posterolateral epidural mass that compressed the dural sac at the L3-4 level. Patient underwent surgery using posterior approach, an L3 laminectomy was performed, the extruded disk fragment was gently removed and L3-L4 interspace was explored. Histopathology confirmed the (PEMLIF). Postoperative course was uneventful.

Keywords: Posterior epidural disk fragment; magnetic resonance imaging; surgery.

Figure 1

Sagittal T1 (A), sagittal T2 (B), and axial (C) T1-weighted MR images revealing a right posterolateral epidural mass (star) that compressed the dural sac at the L3-4 level

Figure 2

Intraoperative photograph of the dural sac after L3 laminectomy showed Extracted disk fragment (pliers) with yellowish appearance and attachment to the posterior dural sac