Left L5/S1 disc extrusion

Case contributed by Dr Derek Smith

Presentation

Left-sided cramping sciatic pain for 6 weeks. Numb toes. Absent ankle jerk. No cauda equina red flag symptoms.

Patient Data

Age: 45 years
Gender: Male
MRI

L4/L5: shallow disc bulge with mild left L4 exit foraminal stenosis, but no neural compression.

L5/S1: central disc extrusion with inferior migration (with signal similar to disc nucleus) resulting in moderate left lateral recess stenosis with displacement and possible compression of the transiting left S1 nerve root.

Normal vertebral body height, marrow signal and spinal alignment.

Normal distal cord and conus. Incidental fatty filum terminale (of no clinical consequence).

No concerning extraspinal finding.

Case Discussion

L5/S1 disc extrusion, small and likely recent, displacing and possibly compressing the left S1 nerve root as imaged.

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Case information

rID: 67951
Published: 2nd May 2019
Last edited: 12th May 2019
System: Spine
Inclusion in quiz mode: Included

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