Intradural lumbar disc herniations at the L1-L2 level: A case study and literature review

Abstract

Background: Intradural disc herniations (IDHs) are rare occurrences (0.26-0.30%), and most frequently involve the lumbar spine at the L4-L5 level. Here, we present a patient with an L1-L2 IDH and reviewed the current literature. Case Description: A 65-year-old female presented with the acute onset of bilateral paraparesis accompanied by urinary dysfunction.The lumbar MRI showed a mass at the L1-L2 level with caudal migration, accompanied by a positive “hawk-beak” sign. At surgery, consisting of a L1-L2 laminectomy, a large IDH was encountered responsible for marked cauda equina/root compression. Postoperatively, the patient immediately fully recovered. The literature we identified cited just seven similar studies of L1-L2 IDH. Conclusion: In a 65-year-old female, an IDH was anticipated at the L1-L2 level due to the combined MR findings of a large L1-L2 mass with caudal migration and the positive “hawk-beak” sign.