Extruded lumbar disc encircling the thecal sac

Case contributed by Chris O'Donnell


Severe lumbar back pain with bilateral calf weakness and numbness. No urinary or fecal incontinence.

Patient Data

Age: 45
Gender: Male

Huge L4/5 disc extrusion passing through the posterior longitudonal ligament with sequestration on the right side to the posterior epidural space causing the ligamentum flavum to be displaced posteriorly (arrow).  Thecal sac is obliterated at this level being displaced towards the left.  Note the sequestrated  disc material posteriorly is slightly hyperintense to the extruded disc

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