Asian Spine J.  2016 Aug;10(4):771-775. 10.4184/asj.2016.10.4.771.

Utility of Discography as a Preoperative Diagnostic Tool for Intradural Lumbar Disc Herniation

Affiliations
  • 1Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan. tomiya@med.osaka-cu.ac.jp
  • 2Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Abstract

Preoperative definitive diagnosis of intradural lumbar disc herniation (ILDH) is difficult despite the availability of various neuroradiological investigative tools. We present a case of ILDH diagnosed preoperatively by discography and computed tomography-discography (disco-CT).The patient was a 63-year-old man with acute excruciating right leg pain. Discography and disco-CT demonstrated leakage of the contrast medium into the intradural space. Based on these findings, a right L5 nerve root disturbance caused by ILDH was diagnosed. A right L5 hemi-laminectomy and a dorsal durotomy were performed. The herniated disc was carefully dissected and then completely removed. Three months after surgery, the patient had fully recovered. This report highlights the importance of making a definitive diagnosis of ILDH preoperatively for better surgical planning and improved clinical outcomes. Furthermore, discography and disco-CT are both useful preoperative diagnostic tools for the diagnosis of ILDH.

Keyword

Intradural lumbar disc herniation; Preoperative diagnosis; Discography

MeSH Terms

Diagnosis
Humans
Intervertebral Disc Displacement
Leg
Middle Aged
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