Posterior epidural mass: can a posteriorly migrated lumbar disc fragment mimic tumour, haematoma or abscess ?

Derincek A., Ozalay M., ŞEN O., Pourbagher A.

ACTA ORTHOPAEDICA BELGICA, vol.75, no.3, pp.423-427, 2009 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 75 Issue: 3
  • Publication Date: 2009
  • Page Numbers: pp.423-427


A 60-year-old woman complained of low back pain radiating to both buttocks and to the anterior aspect of the left thigh. MRI showed a left posterolateral epidural mass at the L1-L2 level. An epidural abscess was suspected, but the biochemistry was normal. Excision yielded complete relief of symptoms. Pathological examination demonstrated that the specimen was a migrated disc fragment. The authors found 29 other cases of disc migration to the posterior epidural space; two of these were at the thoracic level. Eleven of the 27 lumbar cases (40%) were complicated with Cauda Equina Syndrome (CES). MRI is the method of choice to make the diagnosis. The differential diagnosis includes tumour, haematoma and abscess.