Presentation
Chronic lumbar pain and left lower limb radiculopathy. Disc herniation?
Patient Data
Age: 55 years
Gender: Male
From the case:
Lumbar disc herniation and spinal canal stenosis
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Sagittal T2
- Lumbar lordosis diminished. Moderate degenerative changes.
- Diffuse dehydration and flattening of depicted intervertebral discs.
- Caudally oriented L4-5 disc herniation, primarily affecting the left subarticular zone, which compresses the ipsilateral descending nerve root.
- Slightly above the hernia the spinal canal is narrowed to an AP diameter of 6 mm, CSF space around the nerve roots has become virtual.
- Wide bulge of the L5-S1 disc with a central band of T2 hyperintensity indicating annular fissure.
- Status post prior left kidney lower pole resection.
Case Discussion
The direct compression caused by the L4-5 disc herniation explains the predominantly left-sided symptoms, whilst the spinal canal stenosis affects multiple descending nerve roots bilaterally.
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