Massive lumbar disc extrusion

Case contributed by Fatima Ahmad
Diagnosis certain

Presentation

Lower back pain and paresthesia in the left buttock, left thigh and left side of vulva.

Patient Data

Age: 40 years
Gender: Female

Lumbar spine

mri

Massive disc extrusion from the L4/L5 vertebral disc with caudal migration extending down to the S1 level. This causes cauda equina compression.

Further disc protrusion at the L5/S1 level also causes cauda equina compression but is less marked. 

Case Discussion

The patient had subsequent lumbar decompression and discectomies of both L4/L5 and L5/S1 levels.

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