Disc extrusion: L4/L5

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

L5 sciatica bilaterally.

Patient Data

Age: 45 years
mri

At L4/L5 a very large disc extrusion is present, largely filling the canal, displacing the theca posteriorly, with little CSF remains around the cauda equina, on the because the bony canal is actually quite capacious. Both L5 nerve roots are severely compressed in the subarticular recesses. Neural exit foramina are unremarkable.

Vertebral height, disc height and alignment at other levels is unremarkable. The conus terminates at L1 is normal in appearance. No destructive bony lesion. Bone marrow is within normal limits.

  • T11/T12 to L2/L3: normal
  • L3/L4 & L4/L5: minor disc desiccation and a small incomplete central annular fissure
  • L5/S1: normal

Incidental note is made of a hemangioma within the left sacral ala.

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