Sequestered disc extrusion

Case contributed by A.Prof Frank Gaillard

Presentation

Sciatica.

Patient Data

Age: 28
Gender: Male
MRI

Five lumbar type vertebral bodies. There is a concave scoliosis of the lumbar spine.

No abnormality of alignment in the AP plane. No significant marrow lesions. The conus is identified at T12.

No abnormality of proximal cord signal or volume. No intra dural lesion seen.

At the L4-5 there is moderate broad-based disc bulging seen with some extrusion/sequestration of nuclear material in the midline. This extruded/sequestered fragment is up to 14 mm craniocaudal and up to 11 x 5 mm in the transaxial plane. In conjunction with facet hypertrophy there is a moderate central canal stenosis with impingement of the transiting nerve roots particularly right-sided.

At L5-S1 there is mild broad-based annular bulging with facet hypertrophy but no neural impingement.

Case Discussion

An extruded/sequestered lumbar disc which was confirmed at surgery.

Disc nomenclature is important for the common pathology of lumbar disc disease, with extrusion and sequestration being important elements to detail in the report.

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Case information

rID: 47769
Case created: 2nd Sep 2016
Last edited: 20th Apr 2017
System: Spine
Inclusion in quiz mode: Included

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