Work

Tumor-mimicking lumbar intradural disc herniation managed with unilateral biportal endoscopy: a case report

Year: 2026

Type: article

Abstract: Lumbar intradural disc herniation is rare and frequently mimics intraspinal tumors. A 58-year-old man presented with bilateral L5 radiculopathy and motor weakness. Contrast-enhanced magnetic resonance imaging (MRI) demonstrated an enhancing, cystic L4-5 intraspinal mass favoring a nerve sheath tumor. During unilateral biportal endoscopic surgery, epidural decompression revealed no extradural compression, but persistent thecal tension and absent pulsation prompted an 8-mm dorsal durotomy under reduced irrigation pressure. Sequestered disc fragments adherent to the cauda equina were resected piecemeal, while ventral defect exploration was deliberately avoided. The durotomy was closed using a sutureless inlay dural patch. Histopathology confirmed degenerative disc tissue. The patient achieved complete neurological recovery without cerebrospinal fluid leakage or pseudomeningocele on follow-up MRI. Intradural exploration is warranted when unexplained thecal tension persists, and inlay patch repair serves as an effective endoscopic alternative to primary suturing.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjag1021

Authors: Bin He, Tao Huang, Haitao Tan, Zhongsen Meng, Bo Sun

Institution: Hainan Medical University

Language: English

Topic: Spine and Intervertebral Disc Pathology

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000