J Korean Soc Radiol.  2014 Jul;71(1):34-38. 10.3348/jksr.2014.71.1.34.

Dorsal Epidural Migration of Lumbar Sequestered Disc Fragment: Report of Three Cases

• Wee S
• Juhng SK
• Shim DM

• KMID: 1709019
• DOI: http://doi.org/10.3348/jksr.2014.71.1.34

Abstract

Herein we report three cases of dorsal epidural migration of sequestered lumbar disc fragment in male patients older than 60 years. One of the patients underwent a microscopic decompression and discectomy for a herniated lumbar intervertebral disc disease five months ago. The magnetic resonance imaging showed characteristic features of dorsal epidural migration of a sequestered lumbar disc fragment. We suggest that both, older age and previous intervertebral decompression surgery may be the predisposing factors for the dorsal epidural migration of the sequestered lumbar disc fragment.

MeSH Terms

Causality
Decompression
Diskectomy
Humans
Intervertebral Disc
Longitudinal Ligaments
Magnetic Resonance Imaging
Male
Radiculopathy

Figure

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  Fig. 1 95 years old male who presented motor weakness of both lower extremities for 2 weeks. A-D. Sagittal (A-C) and axial (D) MR images show an abnormal mass-like lesion located in dorsal aspect to the epidural space at L3/4 level (arrows). The signal intensity of the lesion is low on T2-weighted images (T2WI) (A, D) and intermediate on T1-weighted images (T1WI) (B), similar to signal intensity of adjacent intervertebral disc on both T1WI and T2WI. Following intravenous gadolinium enhancement (C) the lesion shows rim contrast enhancement on fat saturated T1WI. E. The surgical specimen shows fragmented disc material. F. Photomicrograph with hematoxylin and eosin (× 40) stain shows degenerated nucleus pulposus of the disc.

• 

  Fig. 2 62 years old male who developed severe pain of low back and both lower extremities for a week after lifting the heavy object. A-D. Sagittal (A-C) and axial (D) MR images show an abnormal mass-like lesion located in dorsal aspect to the epidural space at L4/5 level (arrows). The signal intensity of the lesion is low on T2-weighted images (T2WI) (A, C) and intermediate on T1-weighted images (T1WI) (B), similar to signal intensity of adjacent intervertebral disc on both T1WI and T2WI. Following intravenous gadolinium enhancement (B, D) the lesion shows rim contrast enhancement on fat saturated T1WI.

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