MRI
Sagittal STIR
Axial T2
Sagittal T1 fat sat
Sagittal T1 C+ fat sat
Axial T1 C+ fat sat
A well-defined left paracentral intra-spinal epidural soft tissue is seen opposite to the L5 level, measuring about 25 x 17 x 15 mm at maximal CC, AP, and T diameters and eliciting isointense signal in T1 and slightly high signal in STIR, with peripheral enhancement in the post-contrast T1 fat sat images and lies immediately below L4-5 disc that shows annular tear, representing a sequestrated disc material. It is markedly compressing and displacing the thecal sac and cauda equina nerve roots to the right side.
L4-5 mild diffuse disc bulge is seen with left posterolateral tear and sequestrated disc material (described above).
L5-S1 diffuse disc bulge associated with left posterolateral and foraminal protrusion, indenting the thecal sac and causing moderate bilateral foraminal compromise.