J Korean Soc Radiol.  2024 Jan;85(1):3-23. 10.3348/jksr.2023.0154.

Imaging of Sequestered Lumbar Discs

Affiliations
  • 1Departments of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
  • 2Departments of Orthopaedic Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
  • 3Departments of Neurosurgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
  • 4Department of Radiology, Seoul National University Bundang Hospital, Seoul, Korea

Abstract

Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.

Keyword

Disc Sequestration; Intradural Space; Extradural Space; Intervertebral Disc; Magnetic Resonance Imaging; Lumbar
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