J Korean Neurosurg Soc.  2004 Apr;35(4):442-444.

A Case of Posterior Epidural Migration of an Extruded Lumbar Disc Fragment Causing Cauda Equina Syndrome

• Kim JH
• Kong MH
• Lee SK
• Song KY

Abstract

We report a rare case of cauda equina syndrome due to herniated lumbar disc at L4-L5 with a large extruded fragment which was located primarily posterior (dorsal) to the thecal sac. A 44-year-old man has developed lumbago and sciatica one year prior to his visit, but recently motor weakness and voiding difficulty occurred. Lumbar computed tomography scan showed a mass compressing and surrounding the thecal sac at the L4-L5 level. Urgent decompressive lumbar laminectomy was performed. The lesion proved to be a massive extruded disc fragment dorsally located to the thecal sac. It was partially connected with intervertebral disc and removed carefully to prevent dural tear and neural injury. Although sciatica was almost relieved and motor was recovered usefully, voiding difficulty and dysthesia of the lower leg were remained at 6 months follow-up examination.

Keyword

Lumbar disc herniation; Disc migration; Cauda equina syndrome

MeSH Terms

Adult
Cauda Equina*
Follow-Up Studies
Humans
Intervertebral Disc
Laminectomy
Leg
Low Back Pain
Polyradiculopathy*
Sciatica