Cauda equina syndrome
One day history of bilateral leg numbness and left foot drop with decreased perineal sensation.
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Large L3/L4 central disc extrusion directed inferiorly to predominantly lie posterior to L4. This results in severe central spinal canal stenosis with effacement of the CSF surrounding a compressed cauda equina.
No foraminal stenosis. No other intervertebral disc herniation. The remainder of the spinal canal is capacious.
Cauda equina syndrome refers to a collection of symptoms and signs that result from severe compression of the descending lumbar and sacral nerve roots. It is considered a surgical emergency, and this patient proceeded to an L3/4 microdiscectomy and rhizolysis with the resolution of symptoms post-operatively.