Intradural disc herniation at L5 level mimicking an intradural spinal tumor
Intradural disc herniation at L5 level mimicking an intradural spinal tumor
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DOI：
10.1007/s00586-011-1772-z
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发表时间：
2011-07-01
影响因子：
2.8
通讯作者：
Liu, Kan-Nan
中科院分区：
文献类型：
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作者：
Liu, Chang-Chih;Huang, Chih-Ta;Liu, Kan-Nan
硬膜内腰椎间盘突出症是一种罕见的腰椎间盘疾病并发症。椎间盘突出导致硬脑膜撕裂的原因尚不清楚。硬膜内椎间盘突出通常发生在椎间盘水平，常见于L4-L5水平，但也有其他椎间盘水平的报道。然而，椎体中部的硬膜内椎间盘突出在文献中很少见，在放射学评估中与硬膜内髓外脊髓肿瘤的病变相似。虽然磁共振成像(MRI)对这种情况的诊断是有用的，但术前正确诊断通常是困难的，必须在手术中作出明确诊断。我们在此描述一位50岁女性患者，她的下背部疼痛持续6个月，疼痛突然加重，扩散至左腿，双腿麻木达2周。MRI显示L5水平的硬膜内肿块。进行了椎板切除，随后还进行了十二指肠切开术。发现硬膜内椎间盘碎片并将其完全取出。患者于3个月后完全康复。在椎管内肿块病变的鉴别诊断中必须考虑硬膜内腰椎间盘突出症。
Intradural lumbar disc herniation is a rare complication of disc disease. The reason for the tearing of the dura matter by a herniated disc is not clearly known. Intradural disc herniations usually occur at the disc levels and are often seen at L4-L5 level but have also been reported at other intervertebral disc levels. However, intradural disc herniation at mid-vertebral levels is rare in the literature and mimics an intradural extramedullary spinal tumor lesion in radiological evaluation. Although magnetic resonance imaging (MRI) with gadolinium is useful in the diagnosis of this condition, preoperative correct diagnosis is usually difficult and the definitive diagnosis must be made during surgery. We describe here a 50-year-old female patient who presented with pain in the lower back for 6 months and a sudden exacerbation of the pain that spread to the left leg as well as numbness in both legs for 2 weeks. MRI demonstrated an intradural mass at the level of L5. Laminectomy was performed, and subsequently durotomy was also performed. An intradural disc fragment was found and completely removed. The patient recovered fully in 3 months. Intradural lumbar disc herniation must be considered in the differential diagnosis of mass lesions in the spinal canal.