Open AccessUnusual Presentation of Extruded Disc: A Case Report
Author(s) -
Rajesh Pratap Shah,
Bikash Thapa,
Sujata Panta,
Kabita Birat Karmacharya
Publication year - 2021
Publication title -
journal of nepal medical association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.176
H-Index - 19
eISSN - 1815-672X
pISSN - 0028-2715
DOI - 10.31729/jnma.5993
Subject(s) - medicine , epidural space , surgery , presentation (obstetrics) , magnetic resonance imaging , lumbar , abscess , epidural abscess , anatomy , discectomy , intervertebral disc displacement , dorsum , intervertebral disc , dura mater , disc protrusion , lesion , lumbar vertebrae , radiology
A 38-year male presented with severe low back pain radiating towards right lower limb which was progressively increasing with decrease in motor power of the ipsilateral ankle dorsiflexion and toe extension. Magnetic Resonance study with gadolinium suggested dorsal epidural migration of the extruded disc at L4-L5 level compressing the thecal sac, which mimics the differential diagnosis epidural abscess, epidural hematoma, synovial cyst and extradural space-occupying lesion. Open lumbar discectomy was done, and the large, herniated disc was found dorsal to the thecal sac adhering dura mater, which was removed meticulously and the patient was symptomatically better postoperatively. The power of his lower limb gradually increased by physiotherapy in subsequent follow-up.