Tumor-mimicking lumbar intradural disc herniation managed with unilateral biportal endoscopy: a case report
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.
Related
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BibTeX
@article{he2026tumormimicking,
title = {{Tumor-mimicking lumbar intradural disc herniation managed with unilateral biportal endoscopy: a case report}},
author = {Bin He and Tao Huang and Haitao Tan and Zhongsen Meng and Bo Sun},
journal = {Journal of Surgical Case Reports},
year = {2026},
month = nov,
doi = {10.1093/jscr/rjag1021},
url = {https://doi.org/10.1093/jscr/rjag1021},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Tumor-mimicking lumbar intradural disc herniation managed with unilateral biportal endoscopy: a case report
AU - Bin He
AU - Tao Huang
AU - Haitao Tan
AU - Zhongsen Meng
AU - Bo Sun
PY - 2026
DA - 2026/11/05
JO - Journal of Surgical Case Reports
DO - 10.1093/jscr/rjag1021
UR - https://doi.org/10.1093/jscr/rjag1021
AB - 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.
SN - 2042-8812
ER -