Foraminal/extraforaminal lumbar disc extrusion

Case contributed by Dr Bruno Di Muzio

Presentation

Two weeks of lumbar pain with irradiation to the left L3-L4 nerve root territory.

Patient Data

Age: 55 years
Gender: Male
MRI

MRI Lumbar spine

There is a disc extrusion with cephalic migration at the left L3/4 foraminal/extra-foraminal zone causing impingement of the left L3 exiting nerve root. 

CT

CT Lumbar spine

L3/4: There is a broad-based disc bulge with an extruded component that extends into the left foraminal and extraforaminal zones with a superior migration causing impingement of the left L3 exiting root, which has been better demonstrated on the previous MRI. 

Annotated image

Axial disc herniation position

Axial localisation:

  • central
  • subarticular
  • foraminal
  • extraforaminal or lateral
  • anterior

Most sizable disc herniations will occupy more than one zone. 

Illustration by Dr Frank Gaillard

Case Discussion

This case illustrates an acute/subacute disc extrusion in a less common location: the foraminal and extra-foraminal zones (the latter also known as the lateral zone). 

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Case information

rID: 54847
Case created: 1st Aug 2017
Last edited: 8th Aug 2017
Inclusion in quiz mode: Included

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