Volume 53, Number 1 (1/2013) (page : 52-6) Case Report
Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases
Jeong Hoon Choi, MD1;Jin-Sung Kim, MD2;Jee-Soo Jang, MD, PhD1; and Dong Yeob Lee, MD1;
1;Department of Neurosurgery, Wooridul Spine Hospital, Seoul, 2;Spine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

Key words : Nerve rootlet entrapment;Lumbar disc herniation;Laminectomy;Discectomy;Dura tear;Dura repair.