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VOLUME 7 , ISSUE 3 ( September-December, 2022 ) > List of Articles


Contrast-enhancing Sequestered Intervertebral Disc in Lumbosacral Spine: A Case Report and Review of Literature

Pankaj Somani, Shiteez Agarwal, Jitendra Singh, Arvind Ranwa, Anurag Shrivastava, Anchal Chauhan, Anmol Randhawa, Bhawani S Sharma

Keywords : Case report, Low backache, Lumbar disc herniation, Peripheral rim contrast enhancement, Sequestered disc fragment, Severe lumbar canal stenosis

Citation Information : Somani P, Agarwal S, Singh J, Ranwa A, Shrivastava A, Chauhan A, Randhawa A, Sharma BS. Contrast-enhancing Sequestered Intervertebral Disc in Lumbosacral Spine: A Case Report and Review of Literature. J Mahatma Gandhi Univ Med Sci Tech 2022; 7 (3):91-94.

DOI: 10.5005/jp-journals-10057-0219

License: CC BY-NC 4.0

Published Online: 16-09-2023

Copyright Statement:  Copyright © 2022; The Author(s).


A 57-year-old male patient presented with severe low backache associated with left lower limb radiculopathy over the posterolateral aspect of leg and foot for the last 1 month, acute in onset and gradually progressive with left foot drop, and hypoesthesia for the last 10 days. Contrast-enhancing magnetic resonance imaging (CE-MRI) was suggestive of peripheral rim-enhancing sequestered disc fragment in the left posterolateral spinal canal at L4-L5 level, extending into the medial aspect of left neural foramina leading to severe spinal canal stenosis. Microscopic lumbar discectomy was done. A large sequestered disc with granulation tissue was found inside the left neural foramina, densely adherent to adjacent dura mater and nerve root which was removed by careful gentle manipulation and meticulous dissection without dural tear and cerebrospinal fluid (CSF) leak. The patient had significant improvement in his symptoms with complete relief in pain and hypoesthesia immediately after surgery and gradual improvement in the power of the left lower limb from 1/5 to 4/5 over a period of 2 weeks. Here we review the literature and discuss the significance of rim enhancement in the case of sequestered lumbar prolapse intervertebral disc (PIVD) and its differential diagnosis.

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