Intradural lumbar disc herniation after full-endoscopic lumbar discectomy using the interlaminar approach: case report

Abstract

A 67-year-old man complained of the sudden onset of disabling pain in his right leg. He had already undergone full-endoscopic lumbar discectomy, interlaminar (FELD-IL) approach twice for lumbar disc herniation (LDH) at the L4/5 level. MRI showed recurrence of LDH at L4/5 level. Intradural masses were also suspected at the L4 vertebral level. Discography at the L4/5 disc showed contrast medium leakage from the disc to the subarachnoid space. Operation was performed and fragments of the herniated disc were carefully removed under a surgical microscope. The ventral dura mater could be seen adhering to the L4/5 disc. This report is the first documentation of intradural LDH after FELD-IL. Although FELD is less invasive than previous procedures, adhesion between dura mater and surrounding tissues may occur. It is most important to apply discography to confirm the presence of a hole between the intradural space and the disc.

Keywords

Intradural lumbar disc herniation / full-endoscopic lumbar discectomy / discography

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