IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

L5/S1 disc protrusion

Case contributed by Derek Smith
Diagnosis certain

Presentation

Known mild L4/5 disc prolapse - not requiring intervention. Worsening left leg pain and woke with numbness and foot drop. Weak flexors and increased reflexes. Loss of sensation in left L5 distribution. Saddle sensation intact and decent post void volumes.

Patient Data

Age: 35
Gender: Female
mri

Large central disc protrusion at L5/S1 compressing the cauda equina. The epidural fat is nearly completely effaced.
Noncompressive small central disc protrusion at L4/L5.

Degenerate fatty signal at the affected endplates, otherwise normal marrow signal
Normal distal cord and conus.

 

Large central disc protrusion at L5/S1 with cauda equina compression.

Case Discussion

This young patient underwent emergency decompression of the L5/S1 disc protrusion (leading to cauda equina syndrome) with good post-operative results - return to normal mobility and sensation in left leg.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.