Reports (MDPI)最新文献

{"title":"Surgical Management of an Impacted Mandibular Second Premolar in Close Proximity to the Mental Foramen: A Case Report.","authors":"Aikaterini Blouchou, Panagiotis Rafail Peitsinis, Ioannis H Makrygiannis, Gregory Venetis, Ioannis Tilaveridis","doi":"10.3390/reports8030177","DOIUrl":"10.3390/reports8030177","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Tooth impaction is a developmental anomaly characterized by the inability of a tooth to emerge into its predetermined anatomical position within the oral cavity during the normal eruption period. Impaction of the mandibular second premolar is an uncommon condition and poses a heightened risk of neurosensory injury when the tooth is adjacent to the mental foramen. Early diagnosis and precise planning are therefore essential. <b>Case Presentation</b>: This case report presents a rare instance of an asymptomatic impacted mandibular second premolar located in close proximity to the mental foramen in a 44-year-old female patient. The impaction was discovered incidentally on an orthopantomogram, and Cone-Beam Computed Tomography (CBCT) confirmed intimate contact between the root of the impacted second premolar and the mental nerve. Surgical removal was performed under local anesthesia via a conservative triangular flap and a corticotomy window. Platelet-Rich Fibrin (PRF) generated from autologous blood was placed in the socket to foster healing. The proximity of the mental foramen dictated minimal bone removal and atraumatic luxation to avoid nerve stretch or compression. PRF was selected as an effective biomaterial shown to accelerate soft tissue healing and moderate postoperative discomfort, potentially reducing the likelihood of neurosensory disturbance. The socket presented satisfactory healing, and neurosensory function was normal at the first week follow-up and remained normal at 7 months postoperatively (longest follow-up), and no complications were reported by the patient. <b>Conclusions</b>: CBCT-guided planning, meticulous surgical techniques, and adjunctive PRF allowed for safe extraction without post-operative paraesthesia. Timely identification of such rare impactions broadens treatment options and minimizes complications.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retained Intrarenal Guidewire Fragment After Endourological Stone Surgery: Antegrade Percutaneous Snare Retrieval and Literature Review.","authors":"Timoleon Giannakas, Aris Kaltsas, Ornella Moschovaki-Zeiger, Stavros Grigoriadis, Michael Chrisofos","doi":"10.3390/reports8030178","DOIUrl":"10.3390/reports8030178","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Retained intrarenal foreign bodies are rare adverse events after endourological stone surgery. Guidewire fracture or detachment is uncommon and can trigger infection, obstruction, or encrustation if unrecognized. We report antegrade percutaneous snare retrieval of a retained hydrophilic guidewire tip and provide a concise literature review (seven PubMed-indexed intrarenal cases identified by a structured search) to inform diagnosis, management, and prevention. We also clarify the clinical rationale for an antegrade versus retrograde approach and the sequencing of decompression, definitive stone management, and stenting in the context of sepsis. <b>Case Presentation</b>: A 75-year-old woman with diabetes presented with obstructive left pyelonephritis from ureteral and renal calculi. After urgent percutaneous nephrostomy, she underwent semirigid and flexible ureteroscopic lithotripsy with double-J stenting; the nephrostomy remained. During routine tube removal, the stent was inadvertently extracted. Seven days later she re-presented with fever and flank pain. KUB and non-contrast CT showed a linear 4 cm radiopaque foreign body in the left renal pelvis with dilatation. Under local anesthesia and fluoroscopy, a percutaneous tract was used to deploy a 35 mm gooseneck snare and retrieve the distal tip of a hydrophilic guidewire (Sensor/ZIP-type). Inflammatory markers were normalized; the nephrostomy was removed on day 5; six-week imaging confirmed complete clearance without complications. <b>Conclusions</b>: Retained guidewire fragments should be suspected in postoperative patients with unexplained urinary symptoms or infection. Cross-sectional imaging confirms the diagnosis, while minimally invasive extraction-preferably an antegrade percutaneous approach for rigid or coiled fragments-achieves prompt resolution. This case adds to the seven prior PubMed-indexed intrarenal reports identified in our review, bringing the total to eight, underscoring prevention through pre-/post-use instrument checks, immediate fluoroscopy when withdrawal resistance occurs, and structured device accounting to avoid \"never events.\"</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Lasting Cognitive and Physical Impairment After Recreational Use of the Semisynthetic Cannabinoid Hexahydrocannabinonyl (HHC-C9): A Case Report.","authors":"Nanna Reiter, Dorte Fris Palmqvist, Gro Borges Larsen, Mathilde Emilie Høi, Brian Schou Rasmussen, Ragnar Thomsen","doi":"10.3390/reports8030176","DOIUrl":"10.3390/reports8030176","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: The recreational use of semisynthetic cannabinoids (SSCs) is increasing, and SSCs account for more than 40% of all new substances reported at the European level. Although designed to mimic the effects of tetrahydrocannabinol (THC), the primary psychoactive compound in cannabis, evidence suggests that certain SSCs may elicit stronger, prolonged and unintended pharmacological effects. SSCs are easily accessible, particularly via online retailers, but in some countries, SSCs are also sold in convenience stores or specialty stores selling legal low-THC or cannabidiol (CBD) products. Often, SSCs are sold as \"legal highs\" and are found in various forms, including herbal mixtures (spice), vape products, and edibles such as cookies and candies, specifically targeting young users, including children. The products are frequently mislabeled and sold as souvenirs or aromatic potpourri to bypass regulations. <b>Case Presentation</b>: We present a case of a male in his early forties who was admitted to the Emergency Department due to noticeable deficits in alertness and responsiveness after recreational ingestion of two cannabis cookies labeled to contain 40 mg \"CC9\" and a bite of a gummy with unknown contents. The patient experienced vomiting and visual problems, and suffered from nine days of cognitive and physical impairment. HHC-C9, a novel SSC, was detected in blood through forensic toxicological analysis. <b>Conclusions</b>: Recreational use of HHC-C9 can cause vomiting, visual disturbances, and drowsiness, potentially requiring hospital treatment. Potency, clinical effects, and toxicity of SSCs can vary significantly, and in combination with easy accessibility, SSCs pose a potential risk of intoxication to unaware consumers.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Surgical Management of Pancreatic Insulinoma in a Non-Diabetic Patient: A Case Report.","authors":"John Fernando Montenegro, Cristian Eduardo Penagos, Duvy Yasmin Rodríguez, Andres Felipe García-Ramos, Yamil Liscano","doi":"10.3390/reports8030175","DOIUrl":"10.3390/reports8030175","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Endogenous hyperinsulinemic hypoglycemia (HHE) is a rare cause of hypoglycemia, primarily associated with insulinomas, the most common functional pancreatic neuroendocrine tumors. This clinical case explores the diagnostic and therapeutic challenges in patients with recurrent hypoglycemia and no history of diabetes, emphasizing the importance of a multidisciplinary approach to optimize outcomes. <b>Case Presentation:</b> We present a 45-year-old woman presenting with severe hypoglycemic episodes and persistent neuropsychiatric symptoms for over a year. Prolonged fasting tests, insulin and C-peptide level measurements, and specialized imaging studies (endoscopic ultrasound and pancreatic protocol computed tomography) were conducted. Surgical resection of the identified lesion was subsequently performed. Diagnostic studies confirmed a well-differentiated 2.5 cm insulinoma, treated with partial pancreatoduodenectomy. The patient developed postoperative complications that required interdisciplinary management, ultimately achieving clinical stabilization and sustained normoglycemia. <b>Conclusions:</b> This case underscores the importance of considering insulinoma in the differential diagnosis of recurrent hypoglycemia in non-diabetic patients, using Whipple's triad as a key diagnostic criterion. It also highlights the role played by comprehensive strategies combining functional testing (e.g., prolonged fasting) and advanced imaging to ensure timely treatment and reduce the risk of chronic complications.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Naltrexone-Bupropion Therapy for Concurrent Cocaine Use Disorder and Obesity: A Case Report.","authors":"Vincenzo Maria Romeo","doi":"10.3390/reports8030174","DOIUrl":"10.3390/reports8030174","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Cocaine use disorder (CUD) is characterized by recurrent, cue-triggered and intrusive urges to use cocaine (craving), compulsive drug-seeking despite adverse consequences, and impaired control over intake, often co-occurring with excess weight and hedonic overeating. A dual-target rationale supports the fixed-dose naltrexone-bupropion (NB) combination: μ-opioid receptor (MOR) antagonism may mitigate opioid-facilitated mesolimbic reinforcement, while bupropion's catecholaminergic effects and POMC activation support satiety and weight loss. <b>Case Presentation:</b> We describe a case study from an Italian outpatient setting of a 35-year-old man with a 10-year history of CUD, multiple failed detoxifications, and class I obesity (body mass index [BMI] 31 kg/m²) who initiated fixed-dose NB and was followed for 12 weeks under routine care. NB was associated with progressive attenuation of cue-reactive cocaine craving and improved appetite control, alongside clinically meaningful weight reduction, without psychiatric destabilization or emergent safety concerns; medication adherence remained stable. The patient maintained abstinence throughout follow-up and reported improved psychosocial functioning. Quantitatively, CCQ-B scores decreased from 7.2 at baseline to 2.1 at Week 12 (≈70% reduction), while BMI decreased from 31.0 to 25.5 kg/m² (≈-17.7%), with clinically meaningful weight loss and stable adherence. <b>Conclusions:</b> This case study supports the mechanistic rationale that dual NB therapy can simultaneously attenuate cocaine craving and facilitate weight control, addressing two clinically relevant targets in CUD. Although evidence for NB in CUD remains limited and mixed across stimulant populations, this observation highlights a plausible, testable therapeutic hypothesis that integrates mesolimbic and hypothalamic pathways and may inform the design of controlled trials in patients with co-occurring CUD and obesity.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Instability from Cement Pulmonary Embolism Following Vertebroplasty: A Case Report.","authors":"Bogdan Opriță, Georgiana-Loredana Ghinea, Alexandru-Bogdan Dinu, Ruxandra Opriță","doi":"10.3390/reports8030172","DOIUrl":"10.3390/reports8030172","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Percutaneous vertebroplasty is an effective procedure for patients with osteoporosis and fractures. However, notable side effects may occur. Cement leakage into the vascular system may be incidental, with effects ranging from asymptomatic to life-threatening conditions. The treatment of extravasation of the cement and pulmonary embolism does not have definitive guidelines and requires specific treatment for every patient, ranging from basic anticoagulation to surgical procedures. Cement embolisms without periprocedural complications-such as cardiac perforation or massive pulmonary embolism-are often stable. However, symptomatic presentations with hemodynamic instability can occur. We report a clinically significant case of symptomatic cement pulmonary embolism resulting in shock. <b>Case Presentation:</b> A 68-year-old female patient with osteoporosis and a history of cement vertebroplasty two weeks prior to admission for vertebral compression fracture arrived with a three-day history of left leg swelling and shortness of breath. Vital signs revealed hypotension and the lab tests showed elevated lactate and D-dimer, mild leucocystosis, normal PCT and a threefold increase in CRP. The ultrasound confirmed complete thrombosis of the left external iliac and common femoral vein. The thoraco-abdominal CT demonstrated the extravasation of the cement from vertebroplasty to the inferior vena cava, lumbar veins, coupled with multiple cement structures in the segmental lobar pulmonary arteries. The echocardiography showed preserved right ventricular function. The management included intravenous fluids, anticoagulation and norepinephrine. <b>Conclusions:</b> This case underlines that cement pulmonary embolism following vertebroplasty, while typically undetected, can result in significant hemodynamic compromise even in the absence of right heart failure, potentially mediated by an inflammatory response. Importantly, it highlights the possibility of delayed clinical deterioration, with instability manifesting two weeks post-procedure-distinct from the more commonly observed immediate peri-procedural complications or other stable delayed presentation.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Sexual Function and Quality of Life After TVT Surgery in Women with Stress Urinary Incontinence: A Prospective Cohort Study.","authors":"Tamas Szabo, Melinda Ildiko Mitranovici, Janos Turos, Hilda Denes, Raluca Moraru, Lucian Puscasiu","doi":"10.3390/reports8030173","DOIUrl":"10.3390/reports8030173","url":null,"abstract":"<p><p>Involuntary urinary leakage due to stress urinary incontinence in women represents a widespread health condition that reduces quality of life. <b>Background</b>: Treatment with tension-free vaginal tape (TVT) remains the most used procedure, although its impact on quality of life, specifically regarding sexual function effects, has not been thoroughly investigated. The aim of our study is to achieve a broader understanding of the full range of outcomes after surgery, emotional well-being, and sexual function. <b>Materials and Methods</b>: The present prospective cohort study was conducted between 15 July 2023 and 15 June 2024 in the Emergency County Clinical Hospital Targu Mures, Department of Obstetrics and Gynecology. This is an investigation of TVT surgery and its impact on urinary incontinence, conducted by evaluating bladder dysfunction and sexual function before and after surgical intervention, as well as considering physical and psychological outcomes using specific questionnaires. <b>Results:</b> There was a 91.7% objective cure rate for incontinence, while urinary symptoms, sexual function, and emotional health significantly improved, urine leakage associated with strong urgency (<i>p</i> = 0.0002), urine leakage associated with coughing, sneezing, or laughing (<i>p</i> ≤ 0.0001), and patient sexual activity and emotional health also improved after surgery (<i>p</i> ≤ 0.0001). Furthermore, colorectal symptoms improved. <b>Conclusions</b>: This study emphasizes that for the best recovery of sexual and emotional health post-surgery, complete symptom removal is a requirement. Additionally, the significance of combined questionnaires in assessing treatment efficacy is highlighted. A larger sample size of patients and a longer follow-up are required before recommending this procedure as a standard treatment.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the Rovatti Method^® (Physiotherapeutic Scoliosis-Specific Exercises) in an Adolescent Patient with Idiopathic Scoliosis: A Case Report.","authors":"Marco Rovatti, Emanuele Rovatti, Guido Belli, Niccolò Baldoni, Pasqualino Maietta Latessa","doi":"10.3390/reports8030171","DOIUrl":"10.3390/reports8030171","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: The study aims to investigate the application of the Rovatti Method^® in improving Cobb angles, angle of trunk rotation (ATR), aesthetics, and quality of life in the conservative treatment of adolescent idiopathic scoliosis (AIS); <b>Case Presentation</b>: The case concerns the application of the Rovatti Method^® in treating a 13-year-old girl with mild right thoracolumbar AIS. This method involves the use of elastic bands designed to guide and enhance proprioceptive and mechanical stimuli during the patient's active self-correction exercises. The treatment lasted 7 months; a radiographic control showed an improvement in the right thoracolumbar curve, with Cobb angles decreasing from 21° to 14°, ATR from 10° to 8°, TRACE (Trunk Aesthetic Clinical Evaluation) decreasing from 8 to 4 points, and the Scoliosis Research questionnaire (SRS-22) improving from 2.27 to 3.05 points. <b>Conclusions</b>: Concerning this hypothesis-generating observation case, the Rovatti Method^® may represent a kinesiological approach for the treatment of AIS, potentially contributing to improvements in Cobb angles, ATR, aesthetics, and quality of life.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Silent to Life-Threatening: Giant Left Atrial Myxoma Presenting with Acute Pulmonary Edema-A Case Report.","authors":"Ciprian Nicușor Dima, Marinela-Adela Scuturoiu, Iulia-Raluca Munteanu, Alis Liliana Carmen Dema, Horea Bogdan Feier","doi":"10.3390/reports8030170","DOIUrl":"10.3390/reports8030170","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Cardiac myxomas, though typically benign and asymptomatic, can rarely present with acute cardiovascular compromise. We report a case of a left atrial myxoma presenting as acute pulmonary edema in a patient with prior normal cardiac imaging. <b>Case Presentation:</b> A 55-year-old male, with a history of thrombolyzed myocardial infarction and normal coronary angiography and echocardiography five years earlier, was admitted with acute dyspnea and pulmonary edema. Bedside transthoracic echocardiography (TTE) revealed a left atrial mass causing severe mitral inflow obstruction. Emergency surgical excision was performed, and the mass was submitted for histopathological analysis. <b>Discussion:</b> Histology confirmed cardiac myxoma. The procedure and recovery were uneventful, and follow-up at one month confirmed no recurrence. <b>Conclusions:</b> This case illustrates the potential for cardiac myxoma to manifest suddenly with life-threatening symptoms, even after previously normal investigations. Echocardiography remains pivotal in diagnosing intracardiac masses and guiding timely intervention.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Posteriorly Migrated Sequestered Lumbar Disc Herniation Through the Interlaminar Space.","authors":"Merih Can Yilmaz, Keramettin Aydin","doi":"10.3390/reports8030169","DOIUrl":"10.3390/reports8030169","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Posteriorly migrated lumbar disc herniation [PMLDH] is a rare entity that may present with atypical clinical and radiological features, often mimicking other spinal pathologies. Migration of sequestered fragments through the interlaminar space is exceptionally uncommon, and diagnostic challenges are further amplified in the presence of spinal instability. While MRI and CT are generally sufficient for diagnosis, undetected lesions on preoperative imaging may complicate clinical management. <b>Case Presentation</b>: A 59-year-old male presented with acute low back pain and left-sided radiculopathy. Examination revealed mild motor weakness in ankle dorsiflexion. MRI showed L4-L5 segmental instability with central canal stenosis but no migrated disc fragment. Owing to neurological deficit, decompressive laminectomy with posterior instrumentation was performed. Intraoperatively, a posteriorly migrated sequestered fragment compressing the thecal sac was excised and confirmed as degenerative disc material. Postoperatively, the patient's neurological deficit and radicular pain resolved, with no new complaints at 3-month follow-up. <b>Conclusions</b>: This case highlights an unusual presentation of PMLDH in a patient with lumbar stenosis and spinal instability, undetected on preoperative imaging. Recognition of the biomechanical predisposition at the L3-4 and L4-5 levels is important in understanding such rare migrations. Although literature emphasizes early surgical intervention for PMLDH, our patient required urgent surgery due to neurological deficits rather than a definitive preoperative diagnosis. Further studies are warranted to clarify the relationship between instability and posterior migration.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}