Lumbar Disc Herniation: Case Study

38 year old laborer who had the immediate onset of left leg burning pain and weakness after lifting a heavy load. He had onset of some bladder incontinence (which is a surgical emergency).

Images A and B show the very large L4-5 lumbar disc herniation with marked impingement on the neural canal. 

The patient underwent emergent microdiscectomy. He had improvement of his bladder incontinence and improvement of his leg burning pain and weakness. He did have some residual weakness and persistent pain due to the large size of the disc herniation and probable permanent nerve impingement. 

Images C and D show a post-operative MRI scan which reveals removal of the large disc herniation. Note how the disc signal continues to be abnormal, since the disc cannot be returned back to ‘normal’. Although most patients have marked improvement of their leg pain, this patient did develop persistent back and leg pain that required further treatment.