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.
*Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine
†Department of Neurosurgery, Wooridul Spine Hospital, Seoul
‡Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
H.C. and H.Y.S. contributed equally.
The authors declare no conflict of interest.
Reprints: Jin Hoon Park, MD, PhD, Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, 210-711, Korea (e-mail: firstname.lastname@example.org).