Conus medullaris syndrome due to an intradural disc herniation: a case report.
A 70-year-old male patient developed acute paraplegia due to conus medullaris compression secondary to extrusion of D12-L1 disc. After negative epidural examination intraoperatively, a durotomy was performed and an intradural disc fragment was excised. Patient did not regain ambulatory status at two-year follow-up. Intraoperative finding of negative extradural compression, tense swollen dura and CSF leak from ventral dura should alert the surgeon for the possibility of intradural disc herniation. A routine preoperative MRI is misleading and a high index of suspicion helps to avoid a missed diagnosis.
Chaudhary
Kshitij S
KS
Department of Orthopaedics, KEM Hospital, Mumbai, India. chaudhary.kc@gmail.com
Bapat
Mihir R
MR