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Far lateral lumbar disc protrusion

Case contributed by Dr Ian Bickle

Presentation

Right sided back pain. L3 numbness. O/E; 4/5 right proximal leg weakness

Patient Data

Age: 35 years
Gender: Male

Block vertebrae L3/L4 with wasp-waist sign.

Moderate sized right far lateral disc prolapse at L4/L5, completely obliterating the perineural fat in the distal right exit foramen, with impingement of the exiting right L4 nerve root.  The central canal at this level remains capacious.  No impingement of the descending L5 nerve root.

No significant abnormality any other level.

L1 conus. Normal cauda equina.

Case Discussion

Far lateral and foraminal disc prolapses substantiate only a small amount of all disc prolapses.

These are generally harder to identify than central or paracentral disc disease.

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Case information

rID: 76640
Published: 26th Apr 2020
Last edited: 26th Apr 2020
System: Spine
Inclusion in quiz mode: Included

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