Asian Spine J.  2016 Aug;10(4):771-775. 10.4184/asj.2016.10.4.771.

Utility of Discography as a Preoperative Diagnostic Tool for Intradural Lumbar Disc Herniation

• Matsumoto
• Toyoda H
• Terai H
• Dohzono S
• Hori Y
• Nakamura H

• KMID: 2349304
• DOI: http://doi.org/10.4184/asj.2016.10.4.771

Abstract

Preoperative definitive diagnosis of intradural lumbar disc herniation (ILDH) is difficult despite the availability of various neuroradiological investigative tools. We present a case of ILDH diagnosed preoperatively by discography and computed tomography-discography (disco-CT).The patient was a 63-year-old man with acute excruciating right leg pain. Discography and disco-CT demonstrated leakage of the contrast medium into the intradural space. Based on these findings, a right L5 nerve root disturbance caused by ILDH was diagnosed. A right L5 hemi-laminectomy and a dorsal durotomy were performed. The herniated disc was carefully dissected and then completely removed. Three months after surgery, the patient had fully recovered. This report highlights the importance of making a definitive diagnosis of ILDH preoperatively for better surgical planning and improved clinical outcomes. Furthermore, discography and disco-CT are both useful preoperative diagnostic tools for the diagnosis of ILDH.

Keyword

Intradural lumbar disc herniation; Preoperative diagnosis; Discography

MeSH Terms

Diagnosis
Humans
Intervertebral Disc Displacement
Leg
Middle Aged