Migración epidural dorsal de hernia discal lumbar: una causa infrecuente de masa epidural dorsal

Resumen

Posterior epidural migration of lumbar disc fragments is an exceptional variant of disc herniation and represents a diagnostic challenge because of its similarity to other epidural or intradural lesions, including neoplastic processes. We report the case of a 62-year-old woman presenting with severe radicular pain and hypoesthesia, in whom lumbar magnetic resonance imaging demonstrated a dorsal epidural mass at the L1-L2 level with imaging features that raised a broad differential diagnosis, including spinal tumors. Laminectomy and microsurgical resection were performed; histopathological examination confirmed an extruded, sequestered, dorsally migrated disc fragment, with favorable postoperative outcome and complete resolution of radicular pain. This case highlights the importance of including this entity in the differential diagnosis of dorsal epidural masses and supports optimizing magnetic resonance imaging with contrast-enhanced sequences and isotropic volumetric T2-weighted sequences to improve anatomical characterization and surgical planning.