Dorsal Cauda Equina Compression by the Sequestral Lumbar Disk Herniation: A Case Report and the Literature Review

Abstract

A 43-year-old man presented with a 1-week history of progressive weakness of left leg and voiding difficulty. T2-weighted sagittal magnetic resonance image (MRI) showed large size disk extrusion on L4 to L5 level. T1-weighted sagittal MRI with gadolinium enhancement showed rim-enhanced irregularly oval-shaped mass. We performed surgery and removed a large disk particle immediately after partial hemilaminectomy and ligament flavectomy. Disk particles were removed piecemeal. Most common presentation of this pathology was cauda equina syndrome. MRI usually shows rim-enhanced mass-like lesion and partial hemilaminectomy seems to be enough to treat this pathology.