Massive lumbar disc extrusion
Lower back pain and paraesthesia in the left buttock, left thigh and left side of vulva.
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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.
The patient had subsequent lumbar decompression and discectomies of both L4/L5 and L5/S1 levels.