فتق ديسك بين مهره اي در ناحيه كمر

Lumbar Intradural Disc Rupture

Introduction: rupture of intervertebral disc material into the intradural compartment is a rare event, but lumbar disc disease must be considered in differential diagnosis of mass lesion causing nerve rootor cauda-equina syndromes. Any age group with the exception of children can be affected. The neurological symptoms and findings are generally more sever than lateral extradural disc herniation. The purpose of this study is to determine the incidence of lumbar intradural disc rupture and describe its clinical and radiological presentation. Positive mechanical findings suggesting nerve root compression or distortion are found in 75%of these patients. Radiologic evaluation of the patient with suspected intradural disc herniation is most effectively done with a combination of myelography and CT scanning. The treatment of intradural disc herniation is surgical removal. Methods: this descriptive study is from October 1997 to September 2002,2308 patients (mean age: 45.6 years old) with lumbar disc herniation recognized by MRI and / or myelography or CT myelogram who underwent surgery were studied. Results: mean age for this disease has been 45.6 years and males are affected more than females in a ratio of 8 to 2. Neurological findings were motoric, sensory and sphincteric disorders. The most neurological complication was dropfoot. The short time results were good. Conclusion: Lumbar intradural disc herniation must be considered in differential diagnosis of intradural mass lesions. The worse the preoperative deficit, the less likely a postoperative recovery of neurological function, therefore the " time " is very important.