Posterior migration of a lumbar disc fragment: Case report and bibliographic review.

Solapas principales

Bentancourt M. 1, Fernandez M. 2, Nicoli E. 2, Spagnuolo E. 3

ABSTRACT:

 

            A disc herniation is defined as a displacement of disk material beyond the limit of the intervertebral space. If the disk fragment is displaced away from its site of origin, it is named migrated disk. Migration to the posterior epidural space is an extremely uncommon event. A posterior epidural migration of a disk fragment is reported and a bibliographic review is performed.

A patient 42 year-old presented with one-month history of low back pain and lower limb claudication. Three days before admission he experienced weakness on the dorsiflexion of both feet. Magnetic resonance imaging revealed a lesion located on the right posterior epidural space which compressed the dural sac from back to front. Surgery was performed to remove the lesion. Histologic examination confirmed it was an intervertebral disc fragment.

Dorsal migration of disk fragment is found in 0.36% of patients who undergone surgery. There are anatomical barriers that prevent the posterior displacement of the intervertebral disc fragment. It can manifest by low back pain, radicular symptoms or cauda equina compression. Magnetic resonance image are suggestive of this diagnosis. Surgery eliminates local compression and thereby symptoms.

Although it is an uncommon event, symptoms can be extremely invalidating and that is why it should be known.

 

Key Words:Migrated disc herniation, posterior migration, posterior epidural space. 

 

 

  1. Residente de neurocirugía, Unidad Docente Hospital Maciel, Facultad de Medicina
  2. Neurocirujano, Unidad Docente Hospital Maciel, Facultad de Medicina
  3. Jefe del Servicio, Unidad Docente Hospital Maciel, Facultad de Medicina

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