Extruded lumbar disc
Persistent low back pain with radiation into the right upper thigh. Non responsive to conservative management.
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Large L5-S1 paracentral disc prolapse, which is compressing the right side of the thecal sac with resultant canal stenosis.
The disc extrudes cranially and compresses the right S1 descending nerve root in the lateral recess.
Modic changes in the L5-S1 vertebral endplates.
A nice example of a extruded disc prolapse with definitive nerve root impingement.
This case also illustrates the toothpaste sign attributed to an extruded disc when the disc material appears like paste squeezed from a tube of toothpaste.