Dorsal epidural disc migration

Case contributed by Dr Rodrigo Dias Duarte

Presentation

Sudden severe pain, unable to walk. Cauda equina syndrome.

Patient Data

Age: 40 years
Gender: Male

An oval-shaped posterior epidural lesion at the L3/4 level. The signal intensity is similar to the nuclear disc in all sequences and there is peripheral enhancement. There is a posterior annular tear associated.

Severe thecal sac compression, with loss of CSF signal.

Findings are consistent with dorsal epidural disc migration.

Pathology

Surgical specimen. 

Case Discussion

The patient underwent laminectomy and resection of the disc fragment. Dorsal epidural disc migration is rare and it has to be considered when there is a posterior epidural mass. Peripheral enhancement can be seen.

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