Presentation
Back pain with radiculopathy
Patient Data
There is a large posterocentral and right paracentral disc protrusion at the level of L4/L5, which is causing moderate to severe central canal stenosis. It is also effacing the lateral recess bilaterally, right worse than left, with potential for irritation of the descending L5 nerve roots. No significant neural foraminal stenosis is identified.
There is a smaller broad-based left paracentral disc protrusion at L5/S1 causing mild central stenosis.
A large posterocentral and right paracentral disc protrusion at the level of L4/L5, causing moderate to severe central canal stenosis.
Case Discussion
Disc protrusions can cause varying degrees of narrowing of the spinal canal or neural foramina. If large enough, they can cause significant neurological symptoms by compressing the cord, cauda equina nerve roots, or transiting nerves in the lateral recess, in which case, orthopedic spine consultation would be recommended.
Case co-author: Rehana Jaffer, MD, FRCPC
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