Presentation
Right sided back pain. L3 numbness. O/E; 4/5 right proximal leg weakness
Patient Data
Age: 35 years
Gender: Male
From the case:
Far lateral lumbar disc protrusion
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Block vertebrae L3/L4 with wasp-waist sign.
Moderate sized right far lateral disc prolapse at L4/L5, completely obliterating the perineural fat in the distal right exit foramen, with impingement of the exiting right L4 nerve root. The central canal at this level remains capacious. No impingement of the descending L5 nerve root.
No significant abnormality any other level.
L1 conus. Normal cauda equina.
Case Discussion
Far lateral and foraminal disc prolapses substantiate only a small amount of all disc prolapses.
These are generally harder to identify than central or paracentral disc disease.
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