Presentation
5 days of saddle and perineal parenthesis. weak anal wink. PVR 140cc, numbness down Left leg.
Patient Data
L5-S1: There is a large posterior central disc extrusion. This extrusion is indenting anteriorly the thecal sac and conditioning severe central canal stenosis and no CSF surrounding the cauda in the thecal sac. There is strong potential for irritation of the descending right or left S1 nerve roots or other nerve roots within the cauda equina.
There is also severe neural foraminal stenosis secondary to the disc bulging and degenerative facet joint changes, with potential L5 nerve root irritation.
L4-L5: Moderate degenerative intervertebral discopathy and mild diffuse disc bulging slightly asymmetric to the left leading to moderate right and severe left neural foraminal stenosis and potential nerve root irritation of the left L4 exiting nerve root.
Case Discussion
The patient underwent emergency laminectomy and discectomy of the L5/S1 disc extrusion with good post-operative results.