A cauda equina syndrome due to a posterior epidural migration of a lumbar disc herniation

摘要

Purpose. -To discuss through our observation and a review of the literature the neuroradiolo-gical characteristics and the diagnosis difficulties related to this type of migration of lumbar disc herniation. Synthesis of facts. -A 28-year-old weightlifter has presented, after carrying a heavyweight, an acute lumbar pain with paraplegia predominant on the right side and urinary incontinence. MRI has shown a right L4-L5 excluded disc herniation with posterior epidural migration and dural sheath compression. A rapid lumbar spine decompression and herniectomy was performed. A sensitive and motor recovery occurred in the first few days following the operation. After 4 months of follow up, the patient had no neurological sequelae. Conclusion. - Posterior epidural migration of a lumbar disc herniation is rare. Clinical symptoms frequently indicate severe radicular compression. Cauda equina syndrome is very unusual. MRI is very valuable to make the diagnosis. Early surgical management is the treatment of choice for optimal symptomatic recovery.