Percutaneous endoscopic discectomy and dural repair for L3–L4 intradural lumbar disc herniation presenting with cauda equina syndrome: A case report with a literature review

Introduction Intradural lumbar disc herniation (ILDH) is a rare condition causing severe neurological deficits and diagnostic challenges due to overlap with other intradural lesions. Case presentation A 68-year-old male presented with seven-month low back pain, leg numbness, and saddle anesthesia due to L3–L4 ILDH complicated by cauda equina syndrome. Management and outcomes Single-port percutaneous endoscopic discectomy was performed with complete discectomy and dural repair using an artificial patch and biological glue. Postoperatively, the patient showed significant pain relief, improved left leg strength (grade 4.5/5), restored bladder and bowel function, and MRI confirmed adequate decompression. At 1-month follow-up, he regained full independence with only mild residual left leg numbness. Conclusion Single-port endoscopic discectomy effectively treats ILDH with cauda equina syndrome, facilitating significant neurological recovery and supporting minimally invasive approaches.