Presentation
Two weeks of severe right lower back pain radiating into the right groin and testis. Unable to walk upright or extend the knee. Slight dribbling on micturition. Bowels opening normally. No improvement from diazepam or gabapentin.
Patient Data
Age: 45 years
Gender: Male
From the case:
Foraminal disc prolapse
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Focal right L3/L4 foraminal disc prolapse, causing severe narrowing of the right exit foramen and compression of the exiting right L3 nerve root (see annotated key images). The central canal and left exit foramina are capacious at this level.
Minor diffuse disc bulge L5/S1. No canal or foraminal stenosis.
L1 conus. Normal cauda equina.
Case Discussion
A pure foraminal disc prolapse (right sided) at L3/L4 with L3 nerve root impingement.