Acute Intervertebral Disc Herniation

acute intervertebral disc herniation

This 25 year-old male labourer presented with acute back pain and right posterior calf pain after heavy lifting. On examination there was an absent right ankle jerk, but no other neurological signs.
A CT scan was performed, which shows an asymmetrical soft tissue density arising from the L5/S1 disc and protruding into the spinal canal. This is a large right paracentral focal disc protrusion. The L5 nerve roots were not compressed, leaving in the intervertebral foramen above the disc (not shown). The right S1 nerve roots are almost certainly compressed, accounting for the patient’s symptoms and signs.

Reference: Fardon DF, Milette PC. Nomenclature and Classification of Lumbar Disc Pathology. Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology 2003

Credit: Dr Laughlin Dawes