Advertisement

Acta Neurochirurgica

, Volume 110, Issue 3–4, pp 160–165 | Cite as

Intradural disc herniations pathogenesis, clinical picture, diagnosis and treatment

  • A. Yildizhan
  • A. Paşaoğlu
  • T. Okten
  • N. Ekinci
  • K. Aycan
  • Ö. Aral
Clinical Articles

Summary

The relatively rare occurrence and uncertainty about pathogenesis of intradurally displaced disc herniations stimulated an anatomico-pathological study into intradural disc herniations. The relation between the ventral dura and posterior longitudinal ligament in the cervical, thoracic, lumbar and sacral regions were examined macroscopically and microscopically, and ventral and dorsal durai thickness was compared in 20 adult autopsies on patients who died from various causes; in addition, 20 late abortions and newborn cadavers were investigated in the same way.

In this study, a total of 40 autopsies has shown that the ventral dura is most frequently and firmly attached to the posterior longitudinal ligament at the L4–L5 level and these adhesions may be congenital. In the adult cadavers dorsal dura was found to be thicker than the ventral dura in the lumbar and lower cervical interspaces.

Three personal clinical cases of intradurally herniated disc prolapse are shortly described and the diagnosis and management of this pathology discussed.

Keywords

Intervertebral disc displacement intradural disc herniation intradural disc rupture lumbar disc herniated nucleus pulposus 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Blikra G (1969) Intradural herniated lumbar disc. J Neurosurg 31: 676–679PubMedGoogle Scholar
  2. 2.
    Bloom W, Fawcett DW (1975) A textbook of histology. WB Saunders, Philadelphia, pp 375–376Google Scholar
  3. 3.
    Carcavilla LI, Perun JG, Al-Kudsi ER (1982) Hernie discale lombaire intradurale. Rapport de deux cas. Neurochirurgie 28: 421–424PubMedGoogle Scholar
  4. 4.
    Dandy WE, (1942) Serious complications of ruptured intervertebral discs. JAMA 119: 474–475Google Scholar
  5. 5.
    Dürig M, Zdrojewski B (1977) Intradurale Sequestration einer cervikalen Diskushernie: ein kasuistischer Beitrag. Arch Orthop Unfallchir 87: 151–157PubMedGoogle Scholar
  6. 6.
    Fisher RG (1965) Protrusions of thoracic disc. The factor of herniation through the dura mater. J Neurosurg 22: 591–593PubMedGoogle Scholar
  7. 7.
    Hodge CJ, Binet EF, Kieffer SA (1978) Intradural herniation of lumbar intervertebral disc. Spine 3: 346–350PubMedGoogle Scholar
  8. 8.
    Lee ST, Fairholm D (1983) Intradural rupture of lumbar intervertebral disc. Can J Neurol Sci 10: 192–194PubMedGoogle Scholar
  9. 9.
    Lyons AE, Wise BL (1961) Subarachnoid rupture of intervertebral disc fragments. J Neurosurg 18: 242–244PubMedGoogle Scholar
  10. 10.
    Penning L, Wilmink JT (1981) Biomechanics of lumbosacral dural sac. A study of flexion — extension myelography. Spine 4: 398–408Google Scholar
  11. 11.
    Peyser E, Harari A (1977) Intradural rupture of lumbar intervertebral disc: report of two cases with review of the literature. Surg Neurol 8: 95–98PubMedGoogle Scholar
  12. 12.
    Rhodin JAG (1974) Histology. A text and atlas. Oxford University Press, New York London Toronto, pp 322–326Google Scholar
  13. 13.
    Roda JM, Gonzalez C, Balazquez MG,et al (1982) Intradural herniated cervical disc. J Neurosurg 57: 278–280PubMedGoogle Scholar
  14. 14.
    Slater RA, Pineda A, Porter RW (1965) Intradural herniation of lumbar intervertebral discs. Arch Surg 90: 266–269PubMedGoogle Scholar
  15. 15.
    Smith RV (1981) Intradural disc rupture. J Neurosurg 55: 117–120PubMedGoogle Scholar
  16. 16.
    Teng P, Papathedodorou C (1964) Intrathecal dislocation of lumbar intervertebral disc. Neurochirurgia 7: 57–63Google Scholar
  17. 17.
    Truex RC, Carpenter MB (1969) Neuroanatomy. The Williams and Wilkins, Baltimore, pp 12–21Google Scholar
  18. 18.
    Williams PL, Warwick R (1980) Gray's anatomy. Churchill Livingstone, Edinburgh London Melbourne New York, pp 1045–1052Google Scholar
  19. 19.
    Wilson PJE (1962) Cauda equina compression due to intrathecal herniation of an intervertebral disc. Br J Surg 49: 423–428PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • A. Yildizhan
    • 1
  • A. Paşaoğlu
    • 2
  • T. Okten
    • 3
  • N. Ekinci
    • 4
  • K. Aycan
    • 4
  • Ö. Aral
    • 1
  1. 1.Department of NeurosurgeryVakif Gureba HospitalIstanbul
  2. 2.Department of NeurosurgeryErciyes University, School of MedicineKayseriTurkey
  3. 3.Department of PathologyErciyes University, School of MedicineKayseriTurkey
  4. 4.Department of AnatomyErciyes University, School of MedicineKayseriTurkey

Personalised recommendations