L4/L5 foraminal disc prolapse with nerve root impingement

Case contributed by Dr Ian Bickle

Presentation

4 weeks + of lower back pain and radiation into the left buttock. Feels left leg weaker at times, but power 5/5 and sensation normal. No loss of bowel or bladder control. Harder to elicit left knee reflex ?cause/entrapment. Also left hip pain.

Patient Data

Age: 55 years
Gender: Male

Established mild L1 and L2 superior endplate fractures.

Large focal left foraminal disc prolapse at L4/L5 impinging on the exiting L4 nerve root.

The remaining disc levels are normal.

The left sided focal foraminal disc impinging on the L4 nerve root in the exit foramen (inside black circle).

Case Discussion

L4/L5 left foraminal disc prolapse with L4 nerve root impingement. 

A good example of a foraminal disc with consequential nerve root impingement completely fitting with the clinical presentation.

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