Extra-foraminal nerve root compression

Case contributed by Andrew Lawson


Back pain and left leg sciatica.

Patient Data

Age: 50 years
Gender: Male

L4/5: Mild spinal stenosis secondary to a combination of facet joint arthropathy and ligamentum flavum hypertrophy. A large left-sided lateral disc extrusion is present contacting which is compressing the left L4 nerve root lateral to the foramen.

L5/S1: Near complete loss of intervertebral body height with Modic type II changes. Large central and left paracentral disc extrusion contacting the left descending S1 root in the lateral recess. The nerve root is a little swollen. No neural foraminal compromise of the exiting L5 roots.

Case Discussion

It is easy to miss a disc protrusion in the far lateral recess. Consider this as a review area.

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