Posterior epidural migration of extruded lumbar disc fragment mimicking epidural mass: A case report

Introduction: Posterior epidural migration of the lumbar disc fragment is a very rare pathological entity. The pathomechanisms remain unclear. Case presentation: The authors present the case of a 78-year-old Germans male with refractory low back pain. Contrast-MRI showed an epidural mass at the level L1–2 with rim contrast enhancement. The preoperative diagnosis based on the clinical and history of the patient was most probably sequestrated disc fragment migrated posteriorly; differential diagnosis included all other causes of posteriorly located epidural mass.A left interlaminar approach L1–2 was performed. A sticky, capsulated, semi-hard and mobile mass was removed from the posterior epidural spaces. Intraoperative a lateral till the ventral disc fragments were found. An annular tear was found and discectomy was performed. Pathological examination showed a disc tissue with degenerative changes. The patient was pain-free until the last follow-up at 5months. Conclusions: Correlation between relevant clinical information and radiological finding may help to detect the posterior migrated disc fragment.