Extruded lumbar disc

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Persistent low back pain with radiation into the right upper thigh. Non responsive to conservative management.

Patient Data

Age: 43
Gender: Female
mri

Large L5-S1 paracentral disc prolapse, which is compressing the right side of the thecal sac with resultant canal stenosis.

The disc extrudes cranially and compresses the right S1 descending nerve root in the lateral recess.

Modic changes in the L5-S1 vertebral endplates.

Case Discussion

A nice example of a extruded disc prolapse with definitive nerve root impingement.

This case also illustrates the toothpaste sign attributed to an extruded disc when the disc material appears like paste squeezed from a tube of toothpaste.

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