Intradural lumbar disk hernia

Intradural disc herniation is a rare complication of degenerative disc disease. A correct diagnosis of this process is frequently difficult. if this entity is not preoperatively diagnosed and is omitted at surgery, severe neurologic sequels may be provoked. We report a case of a pathologically proven intradural disc herniation preoperatively diagnosed by MR imaging. Clinically, it was manifested by sudden onset of right leg ciatalgia and progressive right lower extremity weakness. The patient also referred a one-month history of sexual dysfunction. MR imaging revealed interruption of the low signal of the anulus fibrosus and of the posterior longitudinal ligament at L2-L3 level and a voluminous disc fragment migrated in the dural sac that showed rim enhancement with gadolinium. The clinical, neuroradiological, and surgical management of lumbar intradural disc herniation are reviewed.