{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:15Z","timestamp":1787755815964,"version":"build-2784847793"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 73-year old man who underwent previous L2-S1 decompression presenting with new right radicular leg pain. Imaging suggests a large central disk herniation at L1-2 with possible intrathecal extension requiring surgical decompression. When positioned prone on a Jackson frame, neuromonitoring motor signals became diminished, and thus, the case was aborted. On returning to the operating room 2 days later, careful positioning in a more neutral\/flexed position facilitated normal neuromonitoring signals, allowing for an uneventful intradural approach and discectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>With conus-level intrathecal disk herniation, consider using prepositional neuromonitoring and avoid hyperextension with positioning to ensure neurological safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.24.00235","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T14:00:39Z","timestamp":1732284039000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Intradural Disk Herniation at the Conus Medullaris"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9855-7442","authenticated-orcid":false,"given":"Michael J.","family":"Kelly","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1501-1952","authenticated-orcid":false,"given":"Marco D.","family":"Burkhard","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5497-6808","authenticated-orcid":false,"given":"Franziska C.S.","family":"Altorfer","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8592-7539","authenticated-orcid":false,"given":"Ronald G.","family":"Emerson","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"Sama","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10]]},"reference":[{"issue":"18","key":"bib1-20250122","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1056\/NEJMcp1512658","article-title":"CLINICAL PRACTICE. herniated lumbar intervertebral disk","volume":"374","author":"Deyo","year":"2016","journal-title":"N Engl J Med."},{"key":"bib2-20250122","doi-asserted-by":"crossref","first-page":"100279","DOI":"10.1016\/j.wnsx.2024.100279","article-title":"Lumbar disc herniation: epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations","volume":"22","author":"Pojskic","year":"2024","journal-title":"World Neurosurg X."},{"issue":"6","key":"bib3-20250122","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1001\/jama.1942.02830230008002","article-title":"Serious complications of ruptured intervertebral disks","volume":"119","author":"Dandy","year":"1942","journal-title":"JAMA."},{"issue":"12","key":"bib4-20250122","doi-asserted-by":"crossref","first-page":"5546","DOI":"10.1016\/j.asjsur.2023.08.043","article-title":"An unusual case report of intradural disc herniation mimicking the spinal intradural tumor","volume":"46","author":"Hu","year":"2023","journal-title":"Asian J Surg."},{"issue":"18","key":"bib5-20250122","doi-asserted-by":"crossref","first-page":"CASE21336","DOI":"10.3171\/CASE21336","article-title":"Intradural lumbar disc herniation: illustrative case","volume":"2","author":"Ihejirika","year":"2021","journal-title":"J Neurosurg Case Lessons."},{"key":"bib6-20250122","doi-asserted-by":"crossref","first-page":"109569","DOI":"10.1016\/j.ejrad.2021.109569","article-title":"Imaging characteristics of intradural disc herniation: a comparison with large disc extrusion","volume":"137","author":"Nam","year":"2021","journal-title":"Eur J Radiol."},{"key":"bib7-20250122","doi-asserted-by":"crossref","first-page":"383451","DOI":"10.1155\/2012\/383451","article-title":"The specific sagittal magnetic resonance imaging of intradural extra-arachnoid lumbar disc herniation","volume":"2012","author":"Sasaji","year":"2012","journal-title":"Case Rep Med."},{"issue":"1","key":"bib8-20250122","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.spinee.2006.02.025","article-title":"Intradural lumbar disc herniation--is it predictable preoperatively? 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