Presentation
Lower back pain with unilateral left lower limb radiation.
Patient Data
Alignment of the lumbosacral spine is normal with preservation of body heights and unremarkable marrow signal. The conus terminates at the inferior aspect of L1 and has a normal appearance. The imaged portion of the lower cord has unremarkable signal on sagittal sequences alone. The paraspinous tissues are unremarkable.
T11/12 and T12/L1: No significant canal or neural frontal stenosis although only sagittal imaging through this level has been performed.
L1/2, L2/3, L3/4, L4/5: No canal, subarticular recess or neural foraminal stenosis.
L5/S1: There is a left paracentral disc protrusion that extends into the subarticular recess with associated mild loss of intervertebral disc height posteriorly and minor disc dessication. This impinges on the descending left S1 nerve at the level of the lateral recess. No significant canal stenosis. The right subarticular recess is unremarkable. No neural foraminal narrowing bilaterally.
S1/2: No neural foraminal stenosis.
Conclusion: Left paracentral/subarticular recess disc protrusion at L5/S1 impinges upon the descending left S1 nerve root at the level of the lateral recess. The rest of the study is unremarkable.
Left paracentral/subarticular recess disc protrusion at L5/S1 impinges upon the descending left S1 nerve root at the level of the lateral recess (yellow line).
Case Discussion
Disc protrusions are a type of disc herniation characterized by protrusion of disc content beyond the normal confines of the intervertebral disc.