Presentation
Prior operation due to L5 disc protrusion. Recurrent lumboischialgic symptoms on the right.
Patient Data
About 14 x 10 x 10 mm low density cystic lesion adjacent to the L3-4 disc in the right paracentral-subarticular zone. The lesion causes mild indentation of the posterior cortex of the L4 vertebra, and resultant cortical thinning.
Moderate degenerative changes of the lumbar spine and intervertebral discs, multisegmental disc bulge most prominent on the L3-4 disc. Narrowing of bilateral L5 nerve root foramina, status post prior disc surgery in the left subarticular zone.
The lesion demonstrates fluid signal on MRI, with a thin rim of enhancement along its capsule. It displaces and compresses the exiting right L4 nerve root, and multiple other descending roots.
Case Discussion
Symptomatic discal cyst, which is hard to appreciate on CT. On MRI the fluid signal is characteristic, while the postcontrast thin peripheral enhancement is further corroborating the benign etiology.
Unable to process the form. Check for errors and try again.