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Intradural lumbar disc herniations: the role of MRI in preoperative diagnosis and review of the literature

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Abstract

The goal of this article is to report our experience on intradural lumbar disc herniation, consider the causes of this pathology, and analyze it from clinical, diagnostic, and therapeutic perspectives with a particular emphasis on the role of MRI in preoperative diagnosis. We analyzed nine patients treated surgically for intradural lumbar disc hernia. All of them underwent surgery, and hemilaminectomy was performed. In six cases, the diagnosis of intradural herniation was definitive and, in the three remaining, it was confirmed at surgery. In five cases, CT (with no contrast medium) of the lumbar area revealed disc herniation, but none could it confirm its intradural location. Myelography was performed in two cases but also could not prove intradural extrusion. Magnetic resonance imaging study was used in four cases. In five, the postoperative outcome has been excellent. Patients 6 and 9 recovered anal function postoperatively; patient 6 suffered from occasional and mild micturition urgency. The three patients previously operated (1, 2, 7) showed good outcome. Presently, we believe that radiologic diagnosis of intradural herniation is possible in carefully selected patients, thanks to MRI with gadolinium.

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References

  1. Acikgoz B, Ozean OE, Iplicioglu C, Saglam S (1986) Intraradicular disc herniation. Neurosurgery 19:673–674

    CAS  Google Scholar 

  2. Alonso-Bartolome P, Canga A, Vasquez-Barquero A, Garcia-Valtuille R, Abascal F, Gerezal L (2001) Intradural lumbar disk hernia. Neurologia 16:181–184

    CAS  PubMed  Google Scholar 

  3. Anda S, Dale LG, Vassal J (1987) Intradural disc herniation with vacuum phenomenon. CT diagnosis. Neuroradiology 29:407

    CAS  PubMed  Google Scholar 

  4. Barbera J, Gonzalez-Darder J, Garcia-Vaquez F (1984) Intraradicular herniated lumbar disc. Case report. J Neurosurg 60:858–860

    CAS  PubMed  Google Scholar 

  5. Benjamin J, Ramesh P Babu (1977) Commento all’articolo di Suzer. Neurosurgery 41:956–959

    Google Scholar 

  6. Blikra G (1969) Intradural herniated lumbar disc. J Neurosurg 31:676–679

    CAS  PubMed  Google Scholar 

  7. Carcavilla LJ, Perun JG, Al-Kudsi ER (1982) Hernie discale lombaire intradurale. Rapport de deux cas. Neurochirurgie 28:421–424

    CAS  PubMed  Google Scholar 

  8. Chowdray V, Greenavar S (1987) Intradural lumbar disc protrusion: a case report. Acta Orthop Scand 58:431–433

    PubMed  Google Scholar 

  9. Ciappetta P, Delfini R, Cantore GP (1981) Intradural lumbar disc hernia. Description of three cases. Neurosurgery 8:104–107

    CAS  PubMed  Google Scholar 

  10. Connolly PJ, Rosenbaum AE, Sacks T, Kopacz KJ (1997) Incomplete intradural lumbar disk herniation. Orthopedics 20:977–979

    CAS  PubMed  Google Scholar 

  11. Coppola AR (1979) pseudoneurilemoma of the spinal canal. South Med J 72:1625–1626

    CAS  PubMed  Google Scholar 

  12. Dandy WE (1942) Serious complications of ruptured intervertebral disks. JAMA 119:474–477

    Google Scholar 

  13. Epstein NE, Syrquin MS, Epstein JA, Decker RE (1990) Intradural disc herniations in the cervical, thoracic, and lumbar spine. Report of three cases and review of the literature. J Spinal Disord 4396–4403

  14. Ergungor MF, Kars HZ (1987) Intraradicular herniation of lumbar disc. A case report. Neuorosurgery 21:909–911

    CAS  Google Scholar 

  15. Fang CM, Huang TJ, Chen WJ, Lee ST, Hsu RW (1994) Intradural lumbar disc herniation. A case report. Chang Keng I Hsueh 17:297–300

    CAS  PubMed  Google Scholar 

  16. Fardoun R, Finn S, Boasson M (1980) Hernie discale lombaire intradurale. A propos d’une observation. Arch Med l’Ovest 12:439–446

    Google Scholar 

  17. Graves VB, Finney HL, Mailander J (1986) Intradural lumbar disk herniation. AJNR Am J Neuroradiol 7:495–497

    CAS  PubMed  Google Scholar 

  18. Hamilton MG, Thomas HG (1990) Intradural herniation of a thoracic disc presenting as flaccid paraplegia. Case report. Neurosurgery 27:482–484

    CAS  PubMed  Google Scholar 

  19. Haughton VM, Eldevik OP, Magnaes B, Amundsen P (1982) A prospective comparison of computed tomography and myelography in the diagnosis of herniated lumbar disks. Radiology 142:103–110

    CAS  PubMed  Google Scholar 

  20. Hida K, Iwasaki Y, Abe H, Shimazaki M, Matsuzaki T (1999) Magnetic resonance imaging of intradural lumbar disc herniation. J Clin Neurosci 6:345–347

    PubMed  Google Scholar 

  21. Hodge CJ, Binet EF, Kieffer SA (1978) Intradural herniation of lumbar intervertebral discs. Spine 3:436–350

    Google Scholar 

  22. Isla AI, Roda JM, Bencosme J, alvarez MP, blazquez MG (1988) Intradural herniated dorsal disc. Case report and review of the literature. Neurosurgery 22:737–739

    CAS  PubMed  Google Scholar 

  23. Jenkins LE, Bowman M, Colter HB, Gildenberg PL (1989) Intradural herniation of a lumbar intervertebral disc. J Spinal Disord 2196–2200

  24. Kaiser MC, Sandt G, Roilgen A, Capesius P, Poos D, Ohanna F (1985) Intradural disk herniation with CT appearance of gas collection. AJNR Am J Neuroradiol 6:117–118

    CAS  PubMed  Google Scholar 

  25. Kataoka O, Nishibayashi Y, Sho T (1989) Intradural lumbar disc herniation. Report of three cases with review of the literature. Spine 14:529–533

    CAS  PubMed  Google Scholar 

  26. Koc RK, Akdemir H, Oktem IS, Menku A (2001) Intradural lumbar disc herniation: report of two cases. Neurosurg Rev 24:44–47

    CAS  PubMed  Google Scholar 

  27. Laneri P, Solinas G, Lisai P (1991) Intradural herniated disk. Report of 2 cases. Arch Putti Chir Organi Mov 39:79–86

    CAS  PubMed  Google Scholar 

  28. Lechowski S, Urbaniak J (1986) Intradural herniation of the intervertebral disk of the cervical segment of the spine. Neurol Neurochir Pol 20:589–591

    CAS  PubMed  Google Scholar 

  29. Lechowski S, Urbaniak J (1986) Intradural herniation of the intervertebral disk of the lumbar segment of the spine. Neurol Neurochir Pol 20:252–257

    CAS  PubMed  Google Scholar 

  30. Lee St, Fairholm D (1983) Intradural rupture of lumbar intervertebral disc. Can J Neurol Sci 10:192–194

    CAS  PubMed  Google Scholar 

  31. Lesoin F, Duquennoy B, Rousseaux M, Servato R, Jomin M (1984) Intradural rupture of lumbar intervertebral disc. Report of three cases with review of the literature. Neurosurgery 14:728–731

    CAS  PubMed  Google Scholar 

  32. Lidov M, Stollman A, Casden A, Som P, Bederson J (1994) MRI of lumbar intradural disc herniation. Clin Imaging 18:173–178

    CAS  PubMed  Google Scholar 

  33. Lyons AE, Wise BL (1961) Subarachnoid rupture of intervertebral disk fragments. J Neurosurg 18:242–244

    CAS  PubMed  Google Scholar 

  34. Mangiaracina A (1963) Un raro caso di prolasso discale intradurale. Ortop Traumatol Apparato Motore 31:97–102

    Google Scholar 

  35. Marega T (1968) Due casi di ernia del disco lombare espulsa nel sacco durale. Arch Putti Chir Organi Mov 23: 467–474

    CAS  PubMed  Google Scholar 

  36. Marega T (1959) Ernia del disco cervicale espulsa nel sacco durale. Arch Putti 12:425–430

    Google Scholar 

  37. Martin N, Guilbeau JC, Murat M, Debroucker T, Bouali I, Nahum H (1988) Hernie discale intradurale lombaire. Diagnostic scanographique. J Radiol 69:681–684

    CAS  PubMed  Google Scholar 

  38. Mercier P, Hayer G, Ben Ali H, Tounsi R, Fournier D, Menei P, Mansour BH, Guy G (1997) Hernies discales lombaires intradurales. A propos de six cas et revue de la littérature. Neurochirurgie 43:142–147

    CAS  PubMed  Google Scholar 

  39. Mikula F, Zapletal B, Fiser Z (1960) Intradurale Prolapse der Lendenbandscheibe. Zbl Neurochir 20:326–333

    CAS  Google Scholar 

  40. Mut M, Berker M, Palaoglu S (2001) Intraradicular disc herniations in the lumbar spine and a new classification of intradural disc herniations. Spinal Cord 39:545–548

    Article  CAS  PubMed  Google Scholar 

  41. Ozer AF, Ozek MM, Pamir MN, Zirh TA, Erzen C (1994) Intradural rupture of cervical vertebral disc. Spine 19:843–845

    CAS  PubMed  Google Scholar 

  42. Paini GP, Baldi PG, Barra N, Pasetti S (1978) Rottura intradurale del disco intervertebrale. Ateneo Parmense Acta Bio-Med 49:189–196

    Google Scholar 

  43. Paini KC, Muduli H, Chander K, Kav VK (1972) Intrathecal disc prolapse associated with lumbar canal stenosis. Neurology (Bombay) 20:64–66

    Google Scholar 

  44. Paterson JE, Gray W (1952) Herniated nucleus pulposus: the free fragment. Br J Surg 39:509–513

    Google Scholar 

  45. Peyser E, Harari A (1977) Intradural rupture of lumbar intervertebral disk. Report of two cases with review of the literature. Surg Neurol 8:95–98

    CAS  PubMed  Google Scholar 

  46. Prestar FJ, Putz R (1982) Das ligamentum longitudinale posterius. Morphologie und Funktion. Morph Med 2:181–189

    Google Scholar 

  47. Prestar FJ, Schattke HH (1995) Intradural disc herniations. Report of three cases. Minim Invas Neurosurg 38:125–128

    CAS  Google Scholar 

  48. Reina EG, Ramirez Calonge E, Maitland Heriot RP (1994) Transdural lumbar disc herniation. Spine 19:617–619

    CAS  PubMed  Google Scholar 

  49. Schisano G, Franco A, Nina P (1995) Intraradicular and intradural lumbar disc herniation. Experiences with nine cases. Surg Neurol 44:536–543

    Article  CAS  PubMed  Google Scholar 

  50. Singounas E, Sakas D, Sourtzis I, Karvounis P (1987) Intradural free fragment of the lumbar region. Report of two cases. Br J Neurosurg 1:137–140

    CAS  PubMed  Google Scholar 

  51. Slater RA, Pineda A, Porter RW (1965) Intradural herniation of lumbar intervertebral discs. Arch Surg 90:266–269

    CAS  PubMed  Google Scholar 

  52. Smith RV (1981) Intradural disc rupture. J Neurosurg 55:117–120

    CAS  PubMed  Google Scholar 

  53. Snow RD, Williams JP, Weber ED, Richardson PH (1995) Enhancing transdural lumbar disk herniation. Clin Imaging 19:12–16

    Article  CAS  PubMed  Google Scholar 

  54. Suzer T, Tahta K, Coskun E (1997) Intraradicular lumbar disc herniation. Case report and review of the literature. Neurosurgery 41:956–959

    CAS  PubMed  Google Scholar 

  55. Taptas JN, Andreadis A, Kordiolis NI (1971) Les hernies lombaires sous-durales. Neurochirurgie 17:51–56

    CAS  PubMed  Google Scholar 

  56. Teng P, Papatheodoru C (1964) Intrathecal dislocation of lumbar intervertebral disc. Neurochirurgia 7:57–63

    Google Scholar 

  57. Wasserstrom R, Mamourian AC, Black JF, Lehman RAW (1993) Intradural lumbar disk fragment with ring enhancement on MR. AJNR Am J Neuroradiol 14:401–404

    CAS  PubMed  Google Scholar 

  58. Whittaker CK, Bernhardt M (1994) Magnetic resonance imaging shows gadolinium enhancement of intradural herniated disc. Spine 19:1505–1507

    CAS  PubMed  Google Scholar 

  59. Wilson PJE (1962) Cauda equina compression due to intrathecal herniation of an intervertebral disk. A case report. Br J Surg 40:423–426

    Google Scholar 

  60. Yldizhan A, Pasaoglu A, Okten T, Ekinci N, Aycan K, Aral O (1991) Intradural disc herniations pathogenesis, clinical picture, diagnosis and treatment. Acta Neurochir (Wien) 110:160–165

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurological Sciences, “La Sapienza” University, Rome, Italy

    Giancarlo D’Andrea, Giuseppe Trillò, Raffaelino Roperto, Paolo Celli, Epimenio Ramundo Orlando & Luigi Ferrante

  2. V. L. Mantegazza 8, 00152, Rome, Italy

    Giancarlo D’Andrea

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  1. Giancarlo D’Andrea
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  2. Giuseppe Trillò
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  3. Raffaelino Roperto
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  6. Luigi Ferrante
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Correspondence to Giancarlo D’Andrea.

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Commentaries on this paper are available at http://dx.doi.org/10.1007/s10143–003-0303-8 and http://dx.doi.org/10.1007/s10143-003-0304-7

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D’Andrea, G., Trillò, G., Roperto, R. et al. Intradural lumbar disc herniations: the role of MRI in preoperative diagnosis and review of the literature. Neurosurg Rev 27, 75–80 (2004). https://doi.org/10.1007/s10143-003-0296-3

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