Summary
The relatively rare occurrence and uncertainty about pathogenesis of intradurally displaced disc herniations stimulated an anatomico-pathological study into intradural disc herniations. The relation between the ventral dura and posterior longitudinal ligament in the cervical, thoracic, lumbar and sacral regions were examined macroscopically and microscopically, and ventral and dorsal durai thickness was compared in 20 adult autopsies on patients who died from various causes; in addition, 20 late abortions and newborn cadavers were investigated in the same way.
In this study, a total of 40 autopsies has shown that the ventral dura is most frequently and firmly attached to the posterior longitudinal ligament at the L4–L5 level and these adhesions may be congenital. In the adult cadavers dorsal dura was found to be thicker than the ventral dura in the lumbar and lower cervical interspaces.
Three personal clinical cases of intradurally herniated disc prolapse are shortly described and the diagnosis and management of this pathology discussed.
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References
Blikra G (1969) Intradural herniated lumbar disc. J Neurosurg 31: 676–679
Bloom W, Fawcett DW (1975) A textbook of histology. WB Saunders, Philadelphia, pp 375–376
Carcavilla LI, Perun JG, Al-Kudsi ER (1982) Hernie discale lombaire intradurale. Rapport de deux cas. Neurochirurgie 28: 421–424
Dandy WE, (1942) Serious complications of ruptured intervertebral discs. JAMA 119: 474–475
Dürig M, Zdrojewski B (1977) Intradurale Sequestration einer cervikalen Diskushernie: ein kasuistischer Beitrag. Arch Orthop Unfallchir 87: 151–157
Fisher RG (1965) Protrusions of thoracic disc. The factor of herniation through the dura mater. J Neurosurg 22: 591–593
Hodge CJ, Binet EF, Kieffer SA (1978) Intradural herniation of lumbar intervertebral disc. Spine 3: 346–350
Lee ST, Fairholm D (1983) Intradural rupture of lumbar intervertebral disc. Can J Neurol Sci 10: 192–194
Lyons AE, Wise BL (1961) Subarachnoid rupture of intervertebral disc fragments. J Neurosurg 18: 242–244
Penning L, Wilmink JT (1981) Biomechanics of lumbosacral dural sac. A study of flexion — extension myelography. Spine 4: 398–408
Peyser E, Harari A (1977) Intradural rupture of lumbar intervertebral disc: report of two cases with review of the literature. Surg Neurol 8: 95–98
Rhodin JAG (1974) Histology. A text and atlas. Oxford University Press, New York London Toronto, pp 322–326
Roda JM, Gonzalez C, Balazquez MG,et al (1982) Intradural herniated cervical disc. J Neurosurg 57: 278–280
Slater RA, Pineda A, Porter RW (1965) Intradural herniation of lumbar intervertebral discs. Arch Surg 90: 266–269
Smith RV (1981) Intradural disc rupture. J Neurosurg 55: 117–120
Teng P, Papathedodorou C (1964) Intrathecal dislocation of lumbar intervertebral disc. Neurochirurgia 7: 57–63
Truex RC, Carpenter MB (1969) Neuroanatomy. The Williams and Wilkins, Baltimore, pp 12–21
Williams PL, Warwick R (1980) Gray's anatomy. Churchill Livingstone, Edinburgh London Melbourne New York, pp 1045–1052
Wilson PJE (1962) Cauda equina compression due to intrathecal herniation of an intervertebral disc. Br J Surg 49: 423–428
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Yildizhan, A., Paşaoğlu, A., Okten, T. et al. Intradural disc herniations pathogenesis, clinical picture, diagnosis and treatment. Acta neurochir 110, 160–165 (1991). https://doi.org/10.1007/BF01400685
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DOI: https://doi.org/10.1007/BF01400685