2022 Volume 13 Issue 7 Pages 970-974
Introduction: A sequestrated lumbar disc hernia in the dorsal epidural space is extremely rare. We report a case of a huge lumber disc hernia in the dorsal epidural space.
Case report: A 65-year-old man. The patient developed sudden gait disturbance due to muscle weakness and pain in both lower extremities. A dorsal epidural lesion located from the L2 upper endplate to the L3 lower endplate was identified in MR imaging. The signal intensity of this lesion was low to iso in T1 and slightly high in T2. Preoperatively, the suspected diagnosis was spinal epidural hematoma; however, the intra- and post-operative diagnosis was sequestrated disc hernia. Sequestrated disc hernia on the dorsal side of dural sac has been reported to occur more frequently in the upper lumber level compared with the usual disc hernia. Although a precise preoperative diagnosis is often difficult, a marginal enhanced effect on Gd contrast-enhanced MR imaging could help to differentiate epidural hematoma from a tumor.
Conclusions: We should consider sequestrated hernia as one of the differential diagnoses for a dorsal epidural lesion in the upper lumber level.
