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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Case report

Discography aids definitive diagnosis of posterior epidural migration of lumbar disc fragments: case report and literature review

Authors: Morito Takano, Tomohiro Hikata, Soraya Nishimura, Michihiro Kamata

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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Abstract

Background

Posterior epidural migration of lumbar disc fragments (PEMLDF) is extremely rare. It is often confused with other posterior lesions and is usually diagnosed intraoperatively. We here describe the use of preoperative discography in the diagnosis of PEMLDF.

Case presentation

A 78-year-old man presented with acute low back pain, gait disturbance, and paresthesia in both legs. Magnetic resonance imaging showed a mass located posteriorly and laterally to the left aspect of the dural sac at the L3 level. The initial diagnosis indicated PEMLDF, malignancy, spontaneous hematoma, or epidural abscess. L3/4 discography clearly showed leakage of the contrast medium into the posterior dural space, indicating PEMLDF. The lesion was identified intraoperatively as a herniated-disc fragment, consistent with the preoperative discography.

Conclusion

PEMDLF is difficult to diagnose preoperatively. Discography is useful for the definitive diagnosis of PEMDLF prior to surgery.
Literature
1.
Lombardi V. Lumbar spinal block by posterior rotation of anulus fibrosus. Case report. J Neurosurg. 1973;39(5):642–7.CrossRefPubMed
2.
Chen CY, Chuang YL, Yao MS, Chiu WT, Chen CL, Chan WP. Posterior epidural migration of a sequestrated lumbar disk fragment: MR imaging findings. AJNR Am J Neuroradiol. 2006;27(7):1592–4.PubMed
3.
Haddadi K, Qazvini HR. Posterior epidural migration of a sequestrated lumbar disk fragment causing cauda equina syndrome in an old patient: a case report. Clin Med Insights Case Rep. 2016;9:39–41.CrossRefPubMedPubMedCentral
4.
Teufack SG, Singh H, Harrop J, Ratliff J. Dorsal epidural intervertebral disk herniation with atypical radiographic findings: case report and literature review. J Spinal Cord Med. 2010;33(3):268–71.CrossRefPubMedPubMedCentral
5.
Turan Y, Yilmaz T, Gocmez C, Ozevren H, Kemaloglu S, Teke M, Sariyildiz MA, Ceviz A, Temiz C. Posterior epidural migration of a sequestered lumbar intervertebral disc fragment. Turk Neurosurg. 2017;27(1):85–94.PubMed
6.
Akhaddar A, El-Asri A, Boucetta M. Posterior epidural migration of a lumbar disc fragment: a series of 6 cases. J Neurosurg Spine. 2011;15(1):117–28.CrossRefPubMed
7.
El Asri AC, Naama O, Akhaddar A, Gazzaz M, Belhachmi A, El Mostarchid B, Boucetta M. Posterior epidural migration of lumbar disk fragments: report of two cases and review of the literature. Surg Neurol. 2008;70(6):668–71. discussion 671.CrossRefPubMed
8.
Robe P, Martin D, Lenelle J, Stevenaert A. Posterior epidural migration of sequestered lumbar disc fragments. Report of two cases. J Neurosurg. 1999;90 Suppl 2:264–6.PubMed
9.
Sengoz A, Kotil K, Tasdemiroglu E. Posterior epidural migration of herniated lumbar disc fragment. J Neurosurg Spine. 2011;14(3):313–7.CrossRefPubMed
10.
Giannini C, Scheithauer BW, Wenger DE, Unni KK. Pigmented villonodular synovitis of the spine: a clinical, radiological, and morphological study of 12 cases. J Neurosurg. 1996;84(4):592–7.CrossRefPubMed
11.
Schellinger D, Manz HJ, Vidic B, Patronas NJ, Deveikis JP, Muraki AS, Abdullah DC. Disk fragment migration. Radiology. 1990;175(3):831–6.CrossRefPubMed
12.
Kuzeyli K, Cakir E, Usul H, Baykal S, Yazar U, Karaarslan G, Arslan E, Peksoylu B. Posterior epidural migration of lumbar disc fragments: report of three cases. Spine (Phila Pa 1976). 2003;28(3):e64–7.
13.
El-Mostarchid B, El-Asri AC, Belhachmi A, Akhaddar A, Gazzaz M, Boucetta M. Posterior epidural migration of a sequestrated lumbar disc fragment. Neurosciences (Riyadh). 2008;13(2):199–200.
14.
Tarukado K, Tono O, Doi T. Ordinary disc herniation changing into posterior epidural migration of lumbar disc fragments confirmed by magnetic resonance imaging: a case report of a successful endoscopic treatment. Asian Spine J. 2014;8(1):69–73.CrossRefPubMedPubMedCentral
15.
Tarukado K, Ikuta K, Fukutoku Y, Tono O, Doi T. Spontaneous regression of posterior epidural migrated lumbar disc fragments: case series. Spine J. 2015;15(6):e57–62.CrossRefPubMed
16.
Lakshmanan P, Ahuja S, Lyons K, Howes J, Davies PR. Sequestrated lumbar intervertebral disc in the posterior epidural space: a report on two cases and review of the literature. Spine J. 2006;6(5):583–6.CrossRefPubMed
17.
18.
Matsumoto T, Toyoda H, Terai H, Dohzono S, Hori Y, Nakamura H. Utility of Discography as a Preoperative Diagnostic Tool for Intradural Lumbar Disc Herniation. Asian Spine J. 2016;10(4):771–5.CrossRefPubMedPubMedCentral
Metadata
Title
Discography aids definitive diagnosis of posterior epidural migration of lumbar disc fragments: case report and literature review
Authors
Morito Takano
Tomohiro Hikata
Soraya Nishimura
Michihiro Kamata
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1516-2

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