Presentation
Known mild L4/5 disc prolapse - not requiring intervention. Worsening left leg pain and woke with numbness and foot drop. Weak flexors and increased reflexes. Loss of sensation in left L5 distribution. Saddle sensation intact and decent post void volumes.
Patient Data
Large central disc protrusion at L5/S1 compressing the cauda equina. The epidural fat is nearly completely effaced.
Noncompressive small central disc protrusion at L4/L5.
Degenerate fatty signal at the affected endplates, otherwise normal marrow signal
Normal distal cord and conus.
Large central disc protrusion at L5/S1 with cauda equina compression.
Case Discussion
This young patient underwent emergency decompression of the L5/S1 disc protrusion (leading to cauda equina syndrome) with good post-operative results - return to normal mobility and sensation in left leg.
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