Disc protrusion impinging upon the descending left S1 nerve

Case contributed by Dr Bruno Di Muzio

Presentation

Lower back pain with unilateral left lower limb radiation.

Patient Data

Age: 32
Gender: Male

MRI Lumbar spine

Modality: MRI

Alignment of the lumbosacral spine is normal with preservation of body heights and unremarkable marrow signal. The conus terminates at the inferior aspect of L1 and has a normal appearance. The imaged portion of the lower cord has unremarkable signal on sagittal sequences alone. The paraspinous tissues are unremarkable.

T11/12 and T12/L1: No significant canal or neural frontal stenosis although only sagittal imaging through this level has been performed.

L1/2, L2/3, L3/4, L4/5: No canal, subarticular recess or neural foraminal stenosis.

L5/S1: There is a left paracentral disc protrusion that extends into the subarticular recess with associated mild loss of intervertebral disc height posteriorly and minor disc dessication. This impinges on the descending left S1 nerve at the level of the lateral recess. No significant canal stenosis. The right subarticular recess is unremarkable. No neural foraminal narrowing bilaterally.

S1/2: No neural foraminal stenosis.

Conclusion: Left paracentral/subarticular recess disc protrusion at L5/S1 impinges upon the descending left S1 nerve root at the level of the lateral recess. The rest of the study is unremarkable.

Modality: Annotated image

Left paracentral/subarticular recess disc protrusion at L5/S1 impinges upon the descending left S1 nerve root at the level of the lateral recess (yellow line).

Case Discussion

Disc protrusions are a type of disc herniation characterised by protrusion of disc content beyond the normal confines of the intervertebral disc

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Case Information

rID: 38790
Case created: 4th Aug 2015
Last edited: 23rd Apr 2017
System: Spine
Tag: rmh
Inclusion in quiz mode: Included

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