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Journal of Korean Neurosurgical Society 2004;35(4): 442-444.
A Case of Posterior Epidural Migration of an Extruded Lumbar Disc Fragment Causing Cauda Equina Syndrome.
Jung Hee Kim, Min Ho Kong, Sang Koo Lee, Kwan Young Song
Department of Neurosurgery, Kangnam General Hospital, Public Corporation, Seoul, Korea. joenamu0@yahoo.co.kr
We report a rare case of cauda equina syndrome due to herniated lumbar disc at L4-L5 with a large extruded fragment which was located primarily posterior (dorsal) to the thecal sac. A 44-year-old man has developed lumbago and sciatica one year prior to his visit, but recently motor weakness and voiding difficulty occurred. Lumbar computed tomography scan showed a mass compressing and surrounding the thecal sac at the L4-L5 level. Urgent decompressive lumbar laminectomy was performed. The lesion proved to be a massive extruded disc fragment dorsally located to the thecal sac. It was partially connected with intervertebral disc and removed carefully to prevent dural tear and neural injury. Although sciatica was almost relieved and motor was recovered usefully, voiding difficulty and dysthesia of the lower leg were remained at 6 months follow-up examination.
Key Words: Lumbar disc herniation; Disc migration; Cauda equina syndrome
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