L5/S1 disc protrusion

Case contributed by Dr Derek Smith


Known mild L4/5 disc prolapse - not requiring intervention. Worsening left leg pain and woke with numbness and foot drop. Weak flexors and increased reflexes. Loss of sensation in left L5 distribution. Saddle sensation intact and decent post void volumes.

Patient Data

Age: 35
Gender: Female

Large central disc protrusion at L5/S1 compressing the cauda equina. The epidural fat is nearly completely effaced.
Noncompressive small central disc protrusion at L4/L5.

Degenerate fatty signal at the affected endplates, otherwise normal marrow signal
Normal distal cord and conus.


Large central disc protrusion at L5/S1 with cauda equina compression.

Case Discussion

This young patient underwent emergency decompression of the L5/S1 disc protrusion (leading to cauda equina syndrome) with good post-operative results - return to normal mobility and sensation in left leg.

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Case information

rID: 34031
Published: 2nd Feb 2015
Last edited: 15th Sep 2019
System: Spine
Inclusion in quiz mode: Included

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