Presentation
Unremitting pain in the left leg.
Patient Data
Age: 45 years
Gender: Male
From the case:
Disc extrusion - toothpaste sign
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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.