Page 171 - Read Online

Hori et al. Mini-invasive Surg 2019;3:21 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.15

Case Report Open Access

Intradural lumbar disc herniation after full-
endoscopic lumbar discectomy using the

interlaminar approach: case report

Takeshi Hori, Kazuo Ohmori, Koichiro Ono

Center for Spinal Surgery, Nippon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki 210-0852, Japan.
Correspondence to: Takeshi Hori, Center for Spinal Surgery, Nippon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki
210-0852, Japan. E-mail: takhori1030@gmail.com
How to cite this article: Hori T, Ohmori K, Ono K. Intradural lumbar disc herniation after full-endoscopic lumbar discectomy
using the interlaminar approach: case report. Mini-invasive Surg 2019;3:21. http://dx.doi.org/10.20517/2574-1225.2019.15
Received: 9 May 2019 First Decision: 9 Jul 2019 Revised: 10 Jul 2019 Accepted: 15 Jul 2019 Published: 20 Jul 2019

Science Editor: Giulio Belli Copy Editor: Jia-Jia Meng Production Editor: Jing Yu

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

INTRODUCTION
Intradural lumbar disc herniation (LDH) is rare, with a reported incidence of 0.26%-0.30% of all cases
[1,2]
[3]
of LDH . The first report of intradural LDH was presented by Dandy in 1942 . Several etiopathologies
of intradural LDH have been suggested, including adhesion between the ventral dura and posterior

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.misjournal.net