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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 674-677
DOI: 10.4103/ajns.AJNS_79_20
Case Report

Missing disc fragment: A rare surgical experience

Abhinandan Mallepally
Department of Spine Services, Indian Spinal Injuries Centre, New Delhi
,
Amrit Gantaguru
Department of Spine Services, Indian Spinal Injuries Centre, New Delhi
,
Nandan Marathe
Department of Spine Services, Indian Spinal Injuries Centre, New Delhi
,
Sanjay Meena
Department of Spine Services, Indian Spinal Injuries Centre, New Delhi
,
Vikas Tandon
Department of Spine Services, Indian Spinal Injuries Centre, New Delhi
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About 35%–72% of lumbar disc herniations are associated with fragment migration. However, the posterior epidural migration is rare. We present a strange situation encountered during surgical decompression of the posterior migrated fragment. A 72-year-old male presented with a history of pain radiating to the left lower limb and Grade 3 power of the extensor hallucis longus. Magnetic resonance imaging revealed a prolapsed intervertebral disc and a possible posterior epidural migration of disc fragment. Routine surgical steps for microdiscectomy were followed after confirmation of level using fluoroscopy. However, the extruded disc fragment was not seen, and both exiting and traversing roots were free with adequate mobility. After extensively searching for a disc in the spinal canal, suction fluid was filtered through a surgical mop used as a sieve. Material collected was sent for histopathological study. Biopsy report confirmed material filtered was indeed the intervertebral disc. Thus, accidental suction of disc material in case of the posterior epidural migrated disc is a possibility, and we should be vigilant about this scenario to avoid disaster.

Key-words:

Lumbar disc herniation - migrated disc fragment - suction

Financial support and sponsorship

Nil.




Publication History

Received: 03 May 2020

Accepted: 22 May 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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