# Transdural Lumbosacral Disc Herniation: When a Benign Pathology Raises Diagnostic and Therapeutic Challenges

## TL;DR

A rare case of transdural disc herniation causing severe symptoms is presented, highlighting the challenges in diagnosis and treatment.

## Contribution

The paper presents a rare clinical case and emphasizes the importance of tailored surgical approaches for transdural disc herniation.

## Key findings

- Transdural disc herniation can present with cauda equina syndrome and requires careful imaging for diagnosis.
- An interspinous surgical approach successfully excised the herniation without complications.
- Literature review suggests tailored surgical planning improves functional outcomes in such cases.

## Abstract

Transdural disc herniation (TDH) is a very rare condition characterized by the displacement of intervertebral disc material transpiercing the thecal sac. A 33-year-old female patient presented to our emergency room with cauda equina syndrome. Upon imaging, we concluded that her clinical presentation was related to an L5-S1 ruptured disc herniation. Through an interspinous surgical approach, we identified a transdural disc herniation that was excised without postoperative complications. We reviewed the literature to highlight special imaging features that may aid in the diagnosis of this particular type of disc herniation and to plan a tailored surgical approach that may improve functional prognosis.