Against the Odds: Massive Lumbar Intradural Disk Herniation in the Elderly

Study Design Case report. Objective Presentation of an unusual case of an elderly patient with massive intradural disk herniation at the L2-L3 level. Methods Clinical and imaging data are presented after obtaining informed consent from the patient. Results A 90-year-old man suffering from sudden-onset neurogenic bladder dysfunction and lower back pain but no further neurologic deficits initially presented with magnetic resonance imaging and laboratory values suggestive of an intraspinal infection. However, intraoperative inspection proved the unexpected finding of a large intradural lumbar disk herniation at the L2-L3 level. Conclusions Lumbar soft disk herniation to the intradural space is a rare event and has never been described in a patient over the age of 75. This case of a 90-year-old man with acute-onset bladder dysfunction underlines the necessity to consider this as a differential diagnosis in the case of a newly diagnosed intradural mass.