Posterior Epidural Migration of Lumbar Intervertebral Disc Fragment Mimicking an Epidural Mass

• Published in: Cureus Vol. 15; no. 10; p. e47522
• Main Authors: Ansari, Ayesha A, Korde, Paresh, Afaque, Syed Yasir, Sawhney, Shraddha, Mishra, Naman
• Format: Report
• Language: English
• Published: 01.10.2023
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.47522

Acute and chronic lower back pain can be commonly caused by intervertebral disc prolapse. This prolapse usually occurs in the dorsal direction and towards the anterior epidural space. In extremely rare cases, this migration/herniation can be seen approaching the posterior epidural space. One such rare instance has been recorded and described in our patient, a 53-year-old with a history of hypertension who presented with persistent lower back pain, radicular in nature, and recent acute aggravation, leading to mobility impairment. The patient experienced numbness in the lower limbs, urinary incontinence, and irregular bowel movements. Sensory deficits were noted along the L3 dermatome. The patient underwent an L3 laminectomy, revealing extruded disk fragments causing the compression. After surgery, the patient's power in the lower limbs began to improve, with significant recovery by discharge and complete resolution of bowel and bladder incontinence. This case highlights the diagnostic and therapeutic challenges of posterior epidural mass-like lesions in the lumbar spine, emphasizing the importance of prompt surgical intervention in restoring neurological function. The successful outcome underscores the significance of early diagnosis and intervention in such cases, ultimately improving the patient's quality of life.