Sequestered lumbar disc with cauda equina compression

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Buttock pain for 10 days. Urinary incontinence 5 days. Normal neurology.

Patient Data

Age: 40 years
Gender: Female

2.5 cm fragment of sequestered L5/S1 disc, lying at the level of the disc space and extending caudally to the S1/S2 disc level. This occupies the majority of the spinal canal with severe compression of the thecal sac and the distal cauda equina. The right S1 descending nerve root is compressed in the lateral recess.

Insignificant diffuse disc bulge at L4/L5.

Case Discussion

Only a small proportion of intervertebral disc disease results in sequestration when the disc material is completely detached from its native disc.

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