Posterior epidural migration of a lumbar intervertebral disc fragment (PEMLIF) is uncommon because of anatomical barriers. It is difficult to diagnose PEMLIF definitively because of its relatively rare incidence and the ambiguity of radiological findings resembling spinal tumors. This case report describes a 76-year-old man with sudden-onset weakness and pain in both legs. Electromyography revealed bilateral lumbosacral polyradiculopathy with a mass-like lesion in L2-3 dorsal epidural space on lumbosacral magnetic resonance imaging (MRI). The lesion showed peripheral rim enhancement on T1-weighted MRI with gadolinium administration. The patient underwent decompressive L2-3 central laminectomy, to remove the mass-like lesion. The excised lesion was confirmed as an intervertebral disc. The possibility of PEMLIF should be considered when rim enhancement is observed in the epidural space on MRI scans and electrodiagnostic features of polyradiculopathy with sudden symptoms of cauda equina syndrome.

Citations

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Diabetic thoracic polyradiculopathy is an unusual cause of severe, chronic abdominal pain in patient with diabetes mellitus of variable duration. The diagnosis can be made by careful history taking, physical examination and paraspinal and abdominal muscle electromyography. Since there are so many diseases that cause similar abdominal pain, it is hard to diagnose diabetic thoracic polyradiculopathy. A 41-year-old female patient with diabetes mellitus had been taken to the department of internal medicine due to unexplained chronic left upper quadrant abdominal pain. Upper gastrointestinal endoscopy, abdominal computed tomography, urologic and gynecologic examinations had been done but failed to find the cause of abdominal pain. We diagnosed chronic abdominal pain of the patient as diabetic thoracic polyradiculopathy confirmed by electromyography and report this case with a brief review of the related literatures. (J Korean Acad Rehab Med 2007; 31: 486-489)