Disc protrusion compressing L5 nerve root

Case contributed by A.Prof Frank Gaillard

Presentation

Left leg pain down to dorsum of foot and big toe.

Patient Data

Age: 65
Gender: Male

The vertebral height, alignment and bone marrow signal are unremarkable, other than an incidental L3 vertebral body haemangioma. The conus terminates at L1/2 and is normal in appearance.

T12/L1 to L3/4: Normal (Upper levels only imaged in sagittal plane)

L4/5: A sizeable left posterolateral focal disc protrusion fills the subarticular recess and severely compresses the descending left L5 nerve root. It results in only minor neural exit foraminal narrowing. The canal is not significant narrowed on the right subarticular recess and foramen are unremarkable.

L5/S1: Broad-based disc protrusion combined with ligamentum flavum hypertrophy and facet joint degenerative change results in mild to moderate narrowing of the neural exit foramina, more so on the left where the exiting L5 nerve root is contacted but not clearly compressed. The canal remains capacious, and the S1 nerve roots are not compressed.

Conclusion:

Severe compression of the descending left L5 nerve root in the subarticular recess of L4/5, with further contact of the same nerve root in the neural exit foramen of L5/S1.

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Case information

rID: 29406
Case created: 23rd May 2014
Last edited: 28th Oct 2015
Tag: spine
Inclusion in quiz mode: Included

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