Intradural disc herniation: how I do it

  • Víctor Rodrigo
  • Marta Claramonte
  • Mónica Martín
  • Juan B. Calatayud
How I Do it - Spine



Intradural disc herniation is a rare phenomenon in spine surgery. Diagnosis is difficult despite current neuroradiologic imaging techniques.


We present a case of a 59-year-old man with lumbar and radicular pain and a recurrent lumbar herniation. A laminectomy was performed after no clear disc herniation in the epidural space was found and an intradural mass was palpable. A durotomy showed an intradural disc fragment that was removed, followed by an arthrodesis.


Only intraoperative findings lead to a definitive diagnosis for intradural herniation. A durotomy needs to be performed. In this case, an arthrodesis was necessary to avoid complications of segmental instability.


Intradural disc herniation Lumbar discectomy Recurrent disc herniation Transdural approach 


Compliance with ethical standards

Informed patient consent

The authors received consent from the patient to participate in the submission.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

Supplemental Digital Content 1

This Video shows the transdural discectomy. (MP4 288,560 kb)


  1. 1.
    Arnold PM, Wakwaya YT (2011) Intradural disk herniation at L1-L2: report of two cases. J Spinal Cord Med 34(3):312–314CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    D’Andrea G, Trillò G, Roperto R, Celli P, Orlando ER, Ferrante L (2004) Intradural lumbar disc herniations: the role of MRI in preoperative diagnosis and review of the literature. Neurosurg Rev 27(2):75–80CrossRefPubMedGoogle Scholar
  3. 3.
    Dandy WE (1942) Serious complications of ruptured intervertebral disks. J Am Med Assoc 119(6):474–477CrossRefGoogle Scholar
  4. 4.
    Ducati LG, Silva MV, Brandão MM, Romero FR, Zanini MA (2013) Intradural lumbar disc herniation: report of five cases with literature review. Eur Spine 22(Suppl 3):S404–S408CrossRefGoogle Scholar
  5. 5.
    Floeth F, Herdmann J (2011) Chronic dura erosion and intradural lumbar disc herniation: CT and MR imaging and intraoperative photographs of a transdural sequestrectomy. Eur Spine J 21:1–5Google Scholar
  6. 6.
    Hidalgo-Ovejero AM, García-Mata S, Gozzi-Vallejo S, Izco-Cabezón T, Martínez-Morentín J, Martínez-Grande M (2004) Intradural disc herniation and epidural gas: something more than a casual association? Spine (Phila Pa 1976) 29(20):E463–E467CrossRefGoogle Scholar
  7. 7.
    Jain SK, Sundar IV, Sharma V, Goel RS, Gupta R (2013) Intradural disc herniation—a case report. Turk Neurosurg 23(3):389–391PubMedGoogle Scholar
  8. 8.
    Schisano G, Franco A, Nina P (1995) Intraradicular and intradural lumbar disc herniation: experiences with nine cases. Surg Neurol 44(6):536–543CrossRefPubMedGoogle Scholar
  9. 9.
    Tempel Z, Zhu X, McDowell MM, Agarwal N, Monaco EA (2016) Severe intradural lumbar disc herniation with cranially oriented free fragment migration. World Neurosurg 92:582.e1–582.e4CrossRefGoogle Scholar
  10. 10.
    Yildizhan A, Pasaoglu A, Okten T, Ekinci N, Aycan K, Aral O (1991) Intradural disc herniations: pathogenesis, clinical picture, diagnosis and treatment. Acta Neurochir 110(3–4):160–165CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Víctor Rodrigo
    • 1
  • Marta Claramonte
    • 1
  • Mónica Martín
    • 1
  • Juan B. Calatayud
    • 1
  1. 1.Department of NeurosurgeryHospital Clínico Universitario Lozano BlesaZaragozaSpain

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