Extruded lumbar disc with cauda equina compression

Case contributed by Ian Bickle


Weakness in both legs.

Patient Data

Age: 35 years
Gender: Male

Normal segmentation.

Large L4/L5 disc extrusion. The extruded disc extends 1.7 cm cranially with the upper end of the extruded disc lying at the superior border of the L4 vertebral body.

Severe compression of the cauda equina from the extruded disc, with no CSF surrounding the cauda in the thecal sac.

The exit foramina are capacious.

Dehydrated L3/L4 and L5/S1 discs. No disc protrusions.  The conus lies at T12.

Case Discussion

This is a really big extruded disc causing cauda equina compression.

The toothpaste sign of an extruded disc is well demonstrated.  The altered signal of the extruded disc is observed in the 'toothpaste' component.

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