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Disc extrusion - toothpaste sign

Case contributed by Dr Ian Bickle


Unremitting pain in the left leg.

Patient Data

Age: 45 years
Gender: Male

Large L5-S1 left paracentral disc extrusion.  

Disc material extrudes and extends caudally filling the left lateral recess, compressing the thecal sac and impinging on the descending S1 nerve root.

No impingement of the exiting L5 root.

The L4-L5 is dehydrated.

Case Discussion

The appearances of a large disc extrusion have been likened on the sagittal plane to toothpaste being squeezed from a tube.

The majority of extrusions extend caudally.

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Case information

rID: 75783
Published: 8th Apr 2020
Last edited: 8th Apr 2020
Inclusion in quiz mode: Included

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