Presentation
Sciatica.
Patient Data
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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