L5/S1 foraminal disc prolapse

Case contributed by Ian Bickle
Diagnosis certain


Sudden onset lower back pain radiating into the left leg reduced range of movement in lower limbs. Severe ongoing pain, numbness in the left leg with power of 4+/5. No better with strong analgesia, weight-bearing only for short periods, no bladder or bowel dysfunction, no saddle anesthesia. Prolapsed disc?

Patient Data

Age: 65 years
Gender: Female

Large focal foraminal disc prolapse at L5/S1 impinging on the exiting left L5 nerve root in the lateral recess/exit foramen. 

Minor diffuse disc bulges at L3/L4 and L4/L5. No canal or exit foraminal stenosis.

The remaining disc levels are normal.

Case Discussion

Foraminal discs are one of the less commonly identified disc prolapses and are infrequent at the L5/S1 level. The disc clearly impinges on the L5 nerve root in the foramen.

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