Pseudointradural/Intraradicular Disc Herniation: A Case Report and Review of the Literature

Year 2010, Volume: 11 Issue: 3, 37 - 40, 16.12.2010

Zahir Kızılay Elif Bolat Abdullah Topçu Feridun Acar

Abstract

Intraradicular disc herniation is a special subtype of intradural disc herniation. Although many theories has been suggested about the formation of intradural discs, the pathophysiology of this pathological state hasn't been explained exactly yet. This state has been classified on the basis of dural anatomy and separated into two subgroups as typeAand B. There is no spesific technique or neuroradiological picture of diagnosing intradural intraradicular disc herniation in the preoperative process. Because of this, the patients are mostly diagnosed intraoperatively and they are even diagnosed in next operations after failed back surgery. In this case report we presented the clinical and radiologic features of a 54 year old female patient with the applying symptom of left sciatalgia and with no spesific findings in her preoperative imaging studies and the literature has been reviewed.

Keywords

Intradural disc herniation, intraradicular disc herniation, lumbar disc herniation

PSÖDOİNTRADURAL/İNTRARADİKÜLER DİSK HERNİASYONU: BİR VAKA SUNUMU VE LİTERATÜRÜN GÖZDEN GEÇİRİLMESİ

Abstract

İntraradiküler disk herniasyonu, intradural disk herniasyonunun özel bir alt tipidir. İntradural disklerin oluşumetyolojisine yönelik birçok teori öne sürülse de bu patolojik durumun oluşum patofizyolojisi tam olarakaçıklanamamıştır. Bu patolojik durum dural anatomi temelinde sınıflandırılarak tip A ve tip B olmak üzere 2 altgruba ayrılmıştır. İntradural intraradiküler disklerin tanımlanmasında preoperatif dönemde bir spesifik yöntemveya görüntüleme bulgusu yoktur. Bu nedenle bu hastaların çoğuna intraoperatif olarak tanı konulmaktadır vehatta başarısız bel cerrahi sonrası ikinci operasyonda tanı almaktadır. Bu vaka sunumunda 54 yaşında, solsiyatalji kliniğiyle başvuran ve yapılan preoperatif görüntüleme tetkiklerinde spesifik bir bulgu saptanmayan birbayan hastanın klinik ve radyolojisi sunularak literatür tekrar gözden geçirildi

Keywords

İntradural disk herniasyonu, intraradiküler disk herniasyonu, lomber disk hernisi

References

• 1. Süzer T, Tahta K, Coşkun E. Intraradicular lumbar disc herniation:case report and review of the literature. Neurosurgery 1997;41(4):956-58.
• 2. Barbera J, Gonzales-Darder J, Garcia-Vazquez F: Intraradicular herniated lumbar disc: Case report. J Neurosurg 1984;60:858-60.
• . Mut M, Berker M, Palaoğlu S. Intraradicular disc herniations in the lumbar spine and a new classification of intradural disc herniations. Spinal Cord 2001;39(10):545-8.
• 4. Ozdemir N, Yilmaz HS, Acar UD, Tektas S. Intraradicular lumbar disc herniation:report two cases and review of the litarature. Br J Neurosurg 2004;18(6):637-43.
• 5. Turgut M, Tekin C, Unsal A. Intraradicular extruded disc herniation as a rare cause of failed back surgerycase a report and review the literature. Neurol Neurochir Pol 2008;42(3):251-4.
• 6. Ozer E, Yurtsever C, Yücesoy K, Güner M. Lumbar intraradicular disc herniation: report of a rare and preoperatively unpredictable case and review of the literature. Spine J 2007;7(1):106-10.
• 7. Tsuji H, Maruta K, Maeda A. Postoperative intraradicular intervertebral disc herniation. Spine 1991;16:998-1000.
• 8. AkhaddarA, Boulahround O, ElasriA, Elmostarchid B, Boucetta M. Radicular intradural lombar disc herniation. Eur Spine J 2010;19 Suppl 2:S149-52.
• 9. Nazzal MM, Croissant PD,Ali MA, et al. Intraradicular lumbar disc herniation: a case report and review of the literature. J Spinal Disord 1995;8:86-8.
• 10. Schisano G, Franco A, Nina P. Intraradicular and intradural lumbar disc herniation: experiences with nine cases. Surg Neurol 1995;44:536-43.
• 11. Schisano G, Nina P. Intraradicular lumbar disc herniation: a case report and review of the literature. Neurosurgery 1998;43:400.
• 12. Karabekir HS, Karagöz Güney F, Kagnici Atar E, et al. Intraradicular lumbar disc herniation: report of two cases.Spinal Cord 2005;44:318-21.
• 13. Finkel HZ. Intraradicular, intervertebral disc herniation.Acase report. Spine 1997;22:1028-9.
• 14. Ergüngör MF, Kars HZ. Intraradicular herniation of a lumbar disc: a case report. Neurosurgery 1987;21:909- 11.
• 15. Akdemir H, Oktem IS, Koç RK, et al. Postoperative intraradicular lumbar disc herniation:a case report. Neurosurg Rew 1997;20:71-4.
• 16. Açıkgöz B, Ozcan OE, Iplikcioğlu C, et al. Intraradicular disc herniation. Neurosurgery 1986;19:673-4.
• 17. Lesoin F, Duquennoy B, Rousseaux M, Servato R, Jormin M. Intradural rupture of lumbar intervertebral disc: report of three cases with review of the literature. Neurosurgery 1984;14(6):728-31.
• 18. Sakai T, Tsuji T, Asazuma T, Yato Y, Matsubara O, Nemoto K. Spontaneous resorption in reccurent intradural lumbar disc herniation: A case report. J Neurosurg Spine 2007;6(6):574-8.
• 19. Lee JS, Suh KT. Intradural disc herniation at L5-S1 mimicking an intradural extramedullary spinal tumor: a case report. J Korean Med Sci 2006;21(4):778-80.
• 20. Borata L, Jonasson P, Agolli A. Spontaneous resorption of intradural lumbar disc fragments. Spine J 2008;8(2):397-403.
• 21. Choi JY, Lee WS, Sung KH. Intradural lumbar disc herniation-is it predictable preoperatively? A report of two cases. Spine J 2007;7(1):111-7.
• 22. Chaudhary KS, Bapat MR. Conus medullaris syndrome due to an intradural disc herniation: A case report. Indian J Orthop 2008;42(1):94-6.
• 23. Oztürk A, Avci E, Yazgan P, Torun F, Yücetas S, Karabag H. Intradural herniation of intervertebral disc at the level of Lumbar 1-Lumbar 2. Turk Neurosurg 2007;17(2):134-7.
• 24. Koç RK, Akdemir H, Oktem IS, Menkü A: Intradural lumbar disc herniation.report of two cases. Neurosurg Rev 2001;24(1):44-7.
• 25. Klopfenstein J, Han PP, Kim L, Spetzler RF. Herniated lumbar disc sequestered between the internal and external dural sleeves: case report . Barrow Quarterly 2003;19:25-7.
• 26. Han IH, Kim KS, Jin BH. Intradural lumbar disc herniations associated with epidural adhesion: report two cases. J Korean Neurosurg Soc 2009;46:168-71.
• 27. Hida K, Iwasaki Y, Abe H, Shimazaki M, Matsuzaki T. Magnetic resonance imaging of intradural lumbar disc herniation. J Clin Neurosci 1999;6(4):345-7