Gadolinium-Enhanced 3-Dimensional MRI for Diagnosis and Surgical Planning of Posterior Epidural Migration of Lumbar Disc Fragment

Case: A 34-year-old man presented at our hospital with knee collapse. Magnetic resonance imaging (MRI) revealed posterior compression of the dural sac by a lumbar epidural lesion; however, a diagnosis could not be reached. Gadolinium (Gd)-enhanced 3-dimensional MRI (3D-MRI) clearly delineated the morphology, enabling us to make a preoperative diagnosis of posterior epidural migration of the lumbar disc fragment (PEMLDF). Furthermore, detailed location information enabled surgical removal of the lesion in a minimally invasive manner. Conclusions: PEMLDF is rare and often difficult to diagnose. Gd-enhanced 3D-MRI provides useful information for the diagnosis and surgical planning for PEMLDF.