Cauda equina syndrome from lumbar disc bulge
Lower limb weakness.
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Disc herniation and congenital spinal canal stenosis are compressing the cauda equina nerve roots. The heterogeneous signal cranial to the level of compression is due to oedematous thickening of the nerves. At the L3/L4 level ligamentum flavum hypertrophy exaggerates the narrowing. The CSF signal is almost completely obliterated.
The cauda equina is compressed by disc herniation and ligamentum flavum hypertrophy at the level of L3/4. There is a background of congenital canal stenosis. This represents one of the many causes of cauda equina syndrome.