Résumé

Introduction:Intradural disc herniation is a rare condition that is difficult to diagnose. Clinical case:A 45-year-old patient was followed for chronic intermittent low back pain and presented acutely with a clinical picture of lumboradicular pain with right S1 deficit associated with urinary disorders. Imaging revealed severe L4-L5 canal stenosis caused by a voluminous disc herniation. Surgical indication was established, with intraoperative search for the hernia resulting in the discovery of an intradural mass. Opening of the dura mater confirmed the herniation, which was completely intradural in median position and covered by nerve rootlets. Removal of the herniation revealed the dural tear, whose edges adhered perfectly to the posterior longitudinal ligament. Improvement of radicular pain was obtained in the immediate postoperative period. Neurological recovery was complete at 3 months. Conclusion:This is a rare condition whose diagnosis is often made intraoperatively. MRI remains the reference examination. Treatment is surgical via an intrathecal approach. Outcome depends on several factors.

Mot-clés :

Intradural Disc Herniation, Sciatica, Cauda Equina Syndrome, Mri