Disc extrusion

Last revised by Mostafa Elfeky on 17 Aug 2024

Disc extrusion is a type of intervertebral disc herniation and is distinguished from a disc protrusion in that it:

  • in at least one plane, has a broader dome (B) than a neck (A)

and/or

  • extends above or below the disc level (into the suprapedicular or infrapedicular zone)

Disc extrusions are associated with a defect in the annulus fibrosus which allows herniation of nucleus pulposus beyond the confines of the disc. Depending on the imaging method, the distinction between extrusion and protrusion may be difficult, in such cases, the general expression "disc herniation" may be used. 

Extrusion can be in any axial direction and may migrate either superiorly or inferiorly. 

Terminology
  • disc protrusion is distinguished from a disc extrusion in that the base of protruded disc material is wider than its 'dome'; furthermore, this protruded disc material must not extend above or below the disc level. 

  • disc sequestration is an extrusion where the disc material migrates and becomes separated from the rest of the herniation.

Note: a number of definitions of what exactly constitutes a disc protrusion have been proposed/used over the years, and it is important to realise that these differ substantially from one another 1-4.  At the time of writing (June 2020) the widely used terminology was proposed in 2014 by Fardon et al and represents a consensus of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology 4

See also

Cases and figures

  • Figure 1: disc extrusion
  • Case 1: foraminal disc extrusion : T2
  • Figure 2
  • Case 2: central disc extrusion : T2
  • Case 3
  • Case 4: left lateral extraforaminal extrusion
  • Case 5: left lateral disc extrusion
  • Case 6: left L4/5 disc extrusion with NRE
  • Case 7: L5-S1 disc extrusion
  • Case 8: large lumbar disc extrusion
  • Case 9
  • Case 10
  • Case 11
  • Case 12
  • Case 13: cervical disc extrusion
  • Case 14
  • Case 15
  • Case 16
  • Case 17: foraminal disc extrusion
  • Case 18: paracentral
  • Case 19: L5/S1 extrusion
  • Case 20: L5/S1 disc extrusion
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