Massive lumbar disc extrusion

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Worsening bilateral leg weakness. No urinary symptoms.

Patient Data

Age: 60 years
Gender: Male
mri

Normal vertebral alignment. No osseous lesion.

Small L3/L4 right paracentral disc protrusion filling the lateral recess and impinging on the descending right L4 nerve root.

Massive L4/L5 disc extrusion with caudal descent of the disc. The disc completely effaces the CSF around the roots of the cauda equina in the thecal sac.

L1 conus.

Case Discussion

Huge lumbar disc extrusion with cauda equina compression.

Interesting the patient attend for this MR as an outpatient and didn't admit to any symptoms indicative of red flag signs. 

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