Transdural Lumbosacral Disc Herniation: When a Benign Pathology Raises Diagnostic and Therapeutic Challenges

Transdural disc herniation (TDH) is a very rare condition characterized by the displacement of intervertebral disc material transpiercing the thecal sac. A 33-year-old female patient presented to our emergency room with cauda equina syndrome. Upon imaging, we concluded that her clinical presentation was related to an L5-S1 ruptured disc herniation. Through an interspinous surgical approach, we identified a transdural disc herniation that was excised without postoperative complications. We reviewed the literature to highlight special imaging features that may aid in the diagnosis of this particular type of disc herniation and to plan a tailored surgical approach that may improve functional prognosis.