{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:39:42Z","timestamp":1783053582428,"version":"3.54.6"},"reference-count":29,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Intradural disc herniations (IDHs) are rare, are difficult to diagnose on preoperative MR\/CT imaging, and typically, are most readily confirmed at the time of surgery. However, one of the greatest challenges posed by these lesions, is the repair of the ventral dural rent.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 55-year-old male with a 20-year history of lumbago presented with low back pain and right lower extremity sciatica of 3 months\u2019 duration. The MR and CT studies showed a compressive lesion at the L1-2 level. There was no original suspicion that this was an IDH. At surgery, performed under the operating microscope, a subtotal L1-L2 laminectomy was performed (i.e. while lysing severe adhesions between the posterior longitudinal ligament and the ventral dura, a traumatic durotomy occurred. White, spongious, friable, soft tissue, and free-floating disc fragments extruded through the durotomy site. Notably, it was initially considered to be a tumor rather than a disc. Once all fragments had been delivered, unsuccessful attempts were made to repair the ventral dura. Further efforts were curtailed due to concern that they would result in damage to multiple ventral nerve rootlets. Despite the lack of primary dural repair, the secondary measures resulted in no postoperative recurrent cerebrospinal fluid leakage (CSF) and a smooth postoperative surgical course.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>IDH at the L1-2 level is rare, and preoperative MR\/CT studies may not always document their intradural location. Ideally, ventral dural tears attributed to these lesions should be directly repaired and\/or managed with additional adjunctive CSF leak repair techniques (i.e. muscle patch grafts, microfibrillar collagen, and fibrin sealants).<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_561_2021","type":"journal-article","created":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T11:04:28Z","timestamp":1626087868000},"page":"351","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Intradural disc herniation at the L1-2 level"],"prefix":"10.25259","volume":"12","author":[{"given":"Hisashi","family":"Serikyaku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichiro","family":"Higa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Yara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,7,12]]},"reference":[{"key":"10.25259\/SNI_561_2021\/ref-1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.25259\/SNI_452_2019","article-title":"Intradural disc herniation at the L1-L2 level: A case report and literature review","volume":"10","author":"Apr\u00edgio","year":"2019","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_561_2021\/ref-2","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1179\/2045772311Y.0000000007","article-title":"Intradural disk herniation at L1-L2: Report of two cases","volume":"34","author":"Arnold","year":"2011","journal-title":"J Spinal Cord Med"},{"key":"10.25259\/SNI_561_2021\/ref-3","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1038\/sj.sc.3101476","article-title":"Intradural disc mimicking: A spinal tumor lesion","volume":"42","author":"Aydin","year":"2004","journal-title":"Spinal Cord"},{"key":"10.25259\/SNI_561_2021\/ref-4","doi-asserted-by":"crossref","first-page":"676","DOI":"10.3171\/jns.1969.31.6.0676","article-title":"Intradural herniated lumbar disc","volume":"31","author":"Blikra","year":"1969","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_561_2021\/ref-5","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4103\/0019-5413.38590","article-title":"Conus medullaris syndrome due to an intradural disc herniation: A case report","volume":"42","author":"Chaudary","year":"2008","journal-title":"Indian J Orthop"},{"key":"10.25259\/SNI_561_2021\/ref-6","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.spinee.2006.02.025","article-title":"Intradural lumbar disc herniationis it predictable preoperatively? A report of two cases","volume":"7","author":"Choi","year":"2007","journal-title":"Spine J"},{"key":"10.25259\/SNI_561_2021\/ref-7","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"},{"key":"10.25259\/SNI_561_2021\/ref-8","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s10143-003-0296-3","article-title":"Intradural lumbar disc herniations: The role of MRI in preoperative diagnosis and review of the literature","volume":"27","author":"D\u2019Andrea","year":"2004","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_561_2021\/ref-9","doi-asserted-by":"crossref","first-page":"S404","DOI":"10.1007\/s00586-012-2516-4","article-title":"Intradural lumbar disc herniation: Report of five cases with literature review","volume":"22","author":"Ducati","year":"2013","journal-title":"Eur Spine J"},{"key":"10.25259\/SNI_561_2021\/ref-10","doi-asserted-by":"crossref","first-page":"S301","DOI":"10.4103\/2152-7806.111427","article-title":"A review article on the diagnosis and treatment of cerebrospinal fluid fistulas and dural tears occurring during spinal surgery","volume":"4","author":"Epstein","year":"2013","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_561_2021\/ref-11","doi-asserted-by":"crossref","first-page":"S453","DOI":"10.1007\/s00586-011-2073-2","article-title":"Chronic dura erosion and intradural lumbar disc herniation: CT and MR imaging and intraoperative photographs of a transdural sequestrectomy","volume":"21","author":"Floeth","year":"2012","journal-title":"Eur Spine J"},{"key":"10.25259\/SNI_561_2021\/ref-12","first-page":"1","article-title":"Transdural lumbar disc herniation: Experiences often ten cases with review of literature","volume":"4","author":"Galhom","year":"2018","journal-title":"J Spine Surg"},{"key":"10.25259\/SNI_561_2021\/ref-13","doi-asserted-by":"crossref","first-page":"168","DOI":"10.3340\/jkns.2009.46.2.168","article-title":"Intradural lumbar disc herniations associated with epidural adhesion: Report of two cases","volume":"46","author":"Han","year":"2009","journal-title":"J Korean Neurosurg"},{"key":"10.25259\/SNI_561_2021\/ref-14","doi-asserted-by":"crossref","first-page":"E463","DOI":"10.1097\/01.brs.0000142433.21912.0d","article-title":"Intradural disc herniation and epidural gas: Something more than a casual association?","volume":"29","author":"Hidalgo-Ovejero","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_561_2021\/ref-15","doi-asserted-by":"crossref","first-page":"392","DOI":"10.22603\/ssrr.2018-0032","article-title":"Pure conus medullaris syndrome without lower extremity involvement caused by intradural disc herniation at L1\/2: A case report","volume":"3","author":"Inoue","year":"2019","journal-title":"Spine Surg Relat Res"},{"key":"10.25259\/SNI_561_2021\/ref-16","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/00007632-200103150-00029","article-title":"Cervical intradural disc herniation","volume":"26","author":"Iwamura","year":"2001","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_561_2021\/ref-17","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1007\/PL00011967","article-title":"Intradural lumbar disc herniation: Report of two cases","volume":"24","author":"Ko\u00e7","year":"2001","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_561_2021\/ref-18","doi-asserted-by":"crossref","first-page":"E763","DOI":"10.1097\/BRS.0b013e31828daa8c","article-title":"Intradural lumbar disc herniation associated with degenerative spine disease and rheumatoid arthritis","volume":"38","author":"Krajewski","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_561_2021\/ref-19","doi-asserted-by":"crossref","first-page":"778","DOI":"10.3346\/jkms.2006.21.4.778","article-title":"Intradural disc herniation at L5-S1 mimicking an intradural extramedullary spinal tumor: A case report","volume":"21","author":"Lee","year":"2006","journal-title":"J Korean Med Sci"},{"key":"10.25259\/SNI_561_2021\/ref-20","doi-asserted-by":"crossref","first-page":"e19025","DOI":"10.1097\/MD.0000000000019025","article-title":"Intradural disc herniation at L4\/5 level causing cauda equina syndrome: A case report","volume":"99","author":"Luo","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"10.25259\/SNI_561_2021\/ref-21","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5334\/jbr-btr.910","article-title":"\u201cCrumble disc sign\u201d: A specific MRI sign of intradural lumbar disc herniation, allowing a preoperative diagnosis","volume":"99","author":"Mailleux","year":"2015","journal-title":"J Belg Soc Radiol"},{"key":"10.25259\/SNI_561_2021\/ref-22","doi-asserted-by":"crossref","first-page":"771","DOI":"10.4184\/asj.2016.10.4.771","article-title":"Utility of discography as a preoperative diagnostic tool for intradural lumbar disc herniation","volume":"10","author":"Matsumoto","year":"2016","journal-title":"Asian Spine J"},{"key":"10.25259\/SNI_561_2021\/ref-23","first-page":"134","article-title":"Intradural herniation of intervertebral disc at the level of lumbar 1-lumbar 2","volume":"17","author":"\u00d6zt\u00fcrk","year":"2007","journal-title":"Turk Neurosurg"},{"key":"10.25259\/SNI_561_2021\/ref-24","doi-asserted-by":"crossref","first-page":"67","DOI":"10.25259\/SNI_108_2020","article-title":"Intradural lumbar disc herniations at the L1-L2 level: A case study and literature review","volume":"11","author":"Ponzo","year":"2020","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_561_2021\/ref-25","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/0090-3019(95)00248-0","article-title":"Intraradicular and intradural lumbar disc herniation: Experiences with nine cases","volume":"44","author":"Schisano","year":"1995","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_561_2021\/ref-26","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3171\/jns.1981.55.1.0117","article-title":"Intradural disc rupture, Report of two cases","volume":"55","author":"Smith","year":"1981","journal-title":"J Neurosrg"},{"key":"10.25259\/SNI_561_2021\/ref-27","doi-asserted-by":"crossref","first-page":"336","DOI":"10.3171\/2014.12.SPINE14682","article-title":"Intradural lumbar disc herniation after percutaneous endoscopic lumbar discectomy: Case report","volume":"23","author":"Tamaki","year":"2015","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI_561_2021\/ref-28","first-page":"9810762","article-title":"Intradural disk herniation mimicking a spinal tumor: Radiologic imaging, pathogenesis, and operative management","volume":"2018","author":"Tateiwa","year":"2018","journal-title":"Case Rep Orthop"},{"key":"10.25259\/SNI_561_2021\/ref-29","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1007\/BF01400685","article-title":"Intradural disc herniations pathogenesis, clinical picture, diagnosis and treatment","volume":"110","author":"Yildizhan","year":"1991","journal-title":"Acta Neurochir (Wien)"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/intradural-disc-herniation-at-the-l1-2-level\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/intradural-disc-herniation-at-the-l1-2-level\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T11:04:56Z","timestamp":1626087896000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/intradural-disc-herniation-at-the-l1-2-level\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,12]]},"references-count":29,"alternative-id":["10.25259\/SNI_561_2021"],"URL":"https:\/\/doi.org\/10.25259\/sni_561_2021","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,12]]},"article-number":"351"}}