Paracentral lumbar disc extrusion

Case contributed by Magdalena Chmiel-Nowak


Back pain with left-sided sciatica.

Patient Data

Age: 40 years
Gender: Female

Desiccation of intervertebral discs L4/L5 and L5/S1, with adjacent Modic type II changes.

Left paracentral L4/L5 disc extrusion with caudal migration, compressing left side of the thecal sac and causing compression of the left L5 spinal nerve root in the stenosed left lateral recess.

Posterior lumbar subcutaneous edema is also noted.

Incidental findings of multiple uterine fibroids. The cystic lesion of 3.5 x 2.5 cm, adjacent to the uterus and most likely left ovary is - given the patient's age - almost certainly benign and requires no follow-up. 

Case Discussion

An example of intervertebral disc extrusion with spinal nerve root compression, causing concordant sciatic pain.

Posterior lumbar subcutaneous edema is a common finding on a lumbar spine MRI. It is speculated that in patients with low back pain it may be a result of decreased lymphatic drainage due to cessation of physical activity because of the pain 1

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