Full-Endoscopic Interlaminar Approach for a Posteriorly Migrated Lumbar Disc Sequestration in a Patient Presenting with Cauda Equina Syndrome and Atypical Magnetic Resonance Imaging Findings: Case Report.
5 affiliations
- 1Department of Neurosurgery, General Hospital of Thessaloniki Georgios Papanikolaou, 57013 Thessaloniki, Greece.
- 2First Department of Neurosurgery, IASO General Clinic, 15123 Athens, Greece.
- 3Department of Pathology, General Hospital of Thessaloniki Georgios Papanikolaou, 57013 Thessaloniki, Greece.
- 4School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
- 5Department of Neurosurgery, 401 General Military Hospital of Athens, 11525 Athens, Greece.
Abstract
Background and Clinical Significance: Posterior epidural migration of a sequestered disc fragment is a very rare entity that may present significant diagnostic challenges, due to radiological characteristics that may mimic other lesions; Case Presentation: A young adult male presented with acute deteriorating low back pain, paraparesis, and urinary incontinence. Magnetic Resonance Imaging (MRI) revealed a massive posterior intraspinal mass causing critical canal stenosis. Although the dorsal location and severe mass effect initially suggested a neoplasm, the complete absence of contrast enhancement strongly pointed toward an avascular lesion. Given the patient's rapid neurological decline, an emergency full-endoscopic left-sided L₄-L₅ interlaminar approach was employed, and a massive free disc fragment was removed. The patient achieved complete motor and sphincter recovery within a month, with mild paresthesia resolving by six months; Conclusions: Posterior epidural migration of a sequestered disc fragment is a rare entity that should be included in the differential diagnosis of posterior intraspinal masses with atypical MRI characteristics. The full-endoscopic interlaminar approach is a viable minimally invasive surgical option.
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BibTeX
@article{theologou2026fullendoscopic,
title = {{Full-Endoscopic Interlaminar Approach for a Posteriorly Migrated Lumbar Disc Sequestration in a Patient Presenting with Cauda Equina Syndrome and Atypical Magnetic Resonance Imaging Findings: Case Report.}},
author = {Marios Theologou and Kassiani Boulogeorgou and Nikolaos Syrmos and Nicoleta Pastelli and Panagiotis Kyriakongonas},
journal = {Reports (MDPI)},
year = {2026},
month = oct,
doi = {10.3390/reports9040361},
url = {https://europepmc.org/article/MED/42924813},
note = {CC BY},
}
RIS
TY - JOUR
TI - Full-Endoscopic Interlaminar Approach for a Posteriorly Migrated Lumbar Disc Sequestration in a Patient Presenting with Cauda Equina Syndrome and Atypical Magnetic Resonance Imaging Findings: Case Report.
AU - Marios Theologou
AU - Kassiani Boulogeorgou
AU - Nikolaos Syrmos
AU - Nicoleta Pastelli
AU - Panagiotis Kyriakongonas
PY - 2026
DA - 2026/10/19
JO - Reports (MDPI)
DO - 10.3390/reports9040361
UR - https://europepmc.org/article/MED/42924813
AB - Background and Clinical Significance: Posterior epidural migration of a sequestered disc fragment is a very rare entity that may present significant diagnostic challenges, due to radiological characteristics that may mimic other lesions; Case Presentation: A young adult male presented with acute deteriorating low back pain, paraparesis, and urinary incontinence. Magnetic Resonance Imaging (MRI) revealed a massive posterior intraspinal mass causing critical canal stenosis. Although the dorsal location and severe mass effect initially suggested a neoplasm, the complete absence of contrast enhancement strongly pointed toward an avascular lesion. Given the patient's rapid neurological decline, an emergency full-endoscopic left-sided L₄-L₅ interlaminar approach was employed, and a massive free disc fragment was removed. The patient achieved complete motor and sphincter recovery within a month, with mild paresthesia resolving by six months; Conclusions: Posterior epidural migration of a sequestered disc fragment is a rare entity that should be included in the differential diagnosis of posterior intraspinal masses with atypical MRI characteristics. The full-endoscopic interlaminar approach is a viable minimally invasive surgical option.
SN - 2571-841X
ER -