Diagnosis and surgical challenges of extremely severe head and lumbar disc herniation in young patients: A case...

Lumbar disc extrusion, a common spinal disorder, is particularly uncommon in its severely displaced form, especially in young patients. This condition can pose diagnostic challenges due to its nonspecific presentation.

A 36-year-old male patient presented with persistent low back pain and radiating leg pain lasting half a month, which had worsened over the previous four days. Lumbar magnetic resonance imaging scans showed an abnormal signal within the vertebral canal at the L3 level, suggesting either a disc cyst or an epidural hematoma. Based on these findings, the patient was provisionally diagnosed with either condition. Surgical exploration was conducted, revealing an extruded lumbar disc, which was subsequently excised. Following surgery, the patient's symptoms completely resolved.

High-grade lumbar disc extrusion in young patients is rare but should be considered in sedentary, physically inactive individuals presenting with lumbocrural pain and abnormal magnetic resonance imaging findings. Early and accurate diagnosis is crucial to avoid misdiagnosis, and prompt open surgery may be necessary in severe cases to alleviate symptoms. The case highlights the impotance of a thorough diagnostic workup and timely surgical intervention in managing such rare but potentially severe spinal disorders.