Abstract Objective:To report a case of intradural disc herniation（IDH） and review relevant literature to explore its epidemiology， etiology， clinical manifestations， imaging features， and treatment strategies， providing clinical guidance for spine surgeons. Methods:A patient presented with a history of low back pain for over 10 years， accompanied by bilateral lower limb numbness for six months and intermittent claudication for more than one month. Preoperative MRI revealed an intraspinal T2hypointense mass at the L4/5 level with discontinuity of the posterior longitudinal ligament. CT indicated spinal stenosis and ossification. The patient underwent durotomy with exploration and intradural disc excision. The case is discussed in conjunction with a literature review. Results:The postoperative course was uneventful, with no complications such as cerebrospinal fluid leakage. Pathology confirmed the excised tissue as nucleus pulposus. Symptoms, including bilateral lower limb numbness, muscle weakness, and intermittent claudication, improved significantly. The Oswestry Disability Index (ODI) decreased from 52% preoperatively to 10% postoperatively. Conclusion:Preoperative diagnosis of intradural disc herniation primarily relies on MRI features (e.g.， interruption of the posterior longitudinal ligament， the "Hawk-beak sign"). However， However, the risk of missed diagnosis or misdiagnosis remains high, necessitating high intraoperative vigilance. Microscope-assisted durotomy with complete disc excision is a safe and effective treatment. Early surgical intervention can significantly improve neurological outcomes. Keywords: Intradural disc herniation； Case report； Diagnosis； Surgical treatment； Prognosis