Dados do Trabalho

Título

INTRADURAL DISC HERNIA: rare condition.

RESUMO

This is a case report with an investigative and descriptive methodology about clinical case of intradural disc hernia, a rare condition that brings a lot of information that can enrich the scientific community – A 65-year-old male patient with a history of low back pain without clinical improvement. Lumbar arthrodesis was performed (L3-4-5-S1). Over the months, he evolved with disease of the adjacent level. Neuroimaging exams such as Magnetic Resonance Imaging (MRI) suggested disease of the adjacent level with extruded hernia. Extensive arthrodesis was then performed. The disease evolved with a degenerative behavior, with disease of the adjacent level and later with junctional kyphosis and paraparesis - requiring a new surgery to understand the arthrodesis again, in which a transoperative diagnosis of intradural hernia was made. Microneurosurgical treatment by arthrodesis was then performed, spinal decompression with wide laminectomy and intradural hernia resection was performed. Postoperatively, he showed significant improvement, returning to ambulation. He later evolved with T8-9 spondylodiscitis that culminated in myelopathy.

Intradural disc herniation is a rare complication: 0.04%. In this way, presenting and discussing the diagnostic (neuroimaging exam) and therapeutic (neurosurgical) procedures associated with the unusual epidemiological picture enriches the literature and medical discussion. There is a higher prevalence in males, mainly affecting the lumbar region. The diagnosis of the disease is difficult, with several differentials in the neuroimaging, and immediate surgery is essential to prevent the progression of the pathology and minimize the patient's discomfort, as well as post-surgical neurofunctional follow-up for rehabilitation.

The present report discusses a lumbar degenerative disease that, after clinical and intraoperative investigation, was diagnosed as an intradural disc herniation, a rare and difficult to diagnose condition. Therefore, the data presented tend to contribute to the collection of clinical history of the disease, enabling the possibility of early and effective diagnoses.

Palavras Chave

Keywords: INTRADURAL DISC HERNIA. Microneurosurgical. Myelopathy.