Dorsal Epidural Lumbar Disc Migration Presenting as Cauda Equina Syndrome
Dorsal epidural lumbar disc migration presenting as cauda equina syndrome (CES) is exceedingly rare and only 38 cases were reported in the literature. The authors presented a 39-year-old male patient presenting with lower back pain of 1-week duration. He developed spontaneous sudden onset of radiati...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Journal of the Scientific Society |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jss.jss_53_24 |
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| Summary: | Dorsal epidural lumbar disc migration presenting as cauda equina syndrome (CES) is exceedingly rare and only 38 cases were reported in the literature. The authors presented a 39-year-old male patient presenting with lower back pain of 1-week duration. He developed spontaneous sudden onset of radiating pain, decreased sensation, and weakness of bilateral lower limbs along with urinary retention and constipation. Motor examination revealed bilateral knees with Medical Research Council Grade 4 power and bilateral ankles with Grade 0 power. Visual analog score (VAS) of pain was 9/10. The patient was diagnosed to have CES. Magnetic resonance imaging (MRI) scan of the lumbosacral spine revealed a well-defined dorsal epidural lesion which appears isointense on T1 and heterogeneously hyperintense on T2-weighted image. Contrast MRI scan revealed peripheral rim enhancement of lesion at L3-4 level suggestive of dorsally migrated L3-4 intervertebral disc. The patient underwent L3 and L4 laminectomy. Dorsally migrated extradural large disc causing severe compression on the dura mater was noted. Extradural disc material was removed and L3-4 discectomy was done. In the postoperative period, the pain was decreased from VAS of 9/10 to VAS of 1/10. Ankle power was improved to Grade 2. Cauda equine syndrome due to dorsal epidural lumbar disc migration can occur spontaneously. It can present as epidural lesion with CES. Surgical removal of the extruded disc carries a good prognosis. |
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| ISSN: | 0974-5009 2278-7127 |