PMC5926215_01
The axial T2-weighted MR scan obtained just above the L3-L4 level documented the foraminal and far lateral extent of the L3-L4 disc herniation (arrow), which migrated superiorly. Note the obliteration of the left-sided cephalad L3 root
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F1
The FOR/FLD disc herniation extended all the way to the L2-L3 level (e.g. markedly compressing the axilla of the L3 root) [Figures 1-4].
The parasagittal T2 MR scan documented the massive left-sided foraminal, far lateral, disc fragment (arrow) originating at the L3-L4 level with substantial superior migration opposite the L3 pedicle
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F2
The FOR/FLD disc herniation extended all the way to the L2-L3 level (e.g. markedly compressing the axilla of the L3 root) [Figures 1-4].
The soft tissue window axial CT obtained just above the L3-L4 disc level similarly documented the foraminal and far lateral extent of the L3-L4 disc herniation (arrow). Note the absence of significant ossification/spur formation
SNI-9-87-g004.jpg
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F3
The FOR/FLD disc herniation extended all the way to the L2-L3 level (e.g. markedly compressing the axilla of the L3 root) [Figures 1-4].
The left-sided parasagittal CT scan, compared with the MR, more poorly documented the massive foraminal, far lateral, disc fragment (arrow) originating at the L3-L4 level with substantial superior migration
SNI-9-87-g005.jpg
PMC5926215_01_SNI-9-87-g005.jpg
F4
The FOR/FLD disc herniation extended all the way to the L2-L3 level (e.g. markedly compressing the axilla of the L3 root) [Figures 1-4].
Penfield elevator in the L3-L4 disc space itself to confirm the correct localization. Note the Penfield/dental tool at the cephalad L2 and caudal L5 extent of the lumbar decompression
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F5
Penfield elevator correctly located within the L3-L4 disc space (e.g. this is used to avoid wrong-level diskectomy) [Figure 5]. Postoperatively, the patient was neurologically intact, and never demonstrated instability.