Intradural Disc Herniation: A Case Report and Literature Review

Abstract

Intradural disc herniation is a rare complication that is difficult to diagnose preoperatively, despite the availability of various radiological imaging tools. We report a case of a 61-year-old man with L4-L5 lumbar disc herniation who presented with back pain radiating to both legs, difficulty in walking, and urinary incontinence. Magnetic resonance imaging showed a disc bulge at the L4-L5 level. However, fragment was not seen until perioperatively; a disc fragment was found in the intradural space. While various radiological techniques have been reported in the literature for diagnosing herniated discs, an absolute diagnosis of intradural disc herniation by a single radiological investigation is unreliable. The current case demonstrates the limitations of various diagnostic methods available. We also present a review of the literature regarding possible modalities to aid diagnosis.